Is medroxyprogesterone safe in women with long QT syndrome?

@article{Skinner2012IsMS,
  title={Is medroxyprogesterone safe in women with long QT syndrome?},
  author={Jonathan R. Skinner and Jamie I. Vandenberg},
  journal={Heart rhythm},
  year={2012},
  volume={9 7},
  pages={
          1148-9
        }
}
G Twenty-two percent of women in the United States use depot medroxyprogesterone acetate (MPA) at some stage in their life for contraception. It is highly effective, can be elf-administered, and has high adherence rates. The World ealth Organization lists it as a first-line option for young omen, particularly those wishing to avoid the adverse ffects of estrogens, such as breast-feeding mothers, smokrs, those who are overweight, and those with atrial fibrilation, pulmonary hypertension… 

References

SHOWING 1-10 OF 10 REFERENCES
Cardiovascular effects of medroxyprogesterone acetate and progesterone: a case of mistaken identity?
TLDR
It is hoped that this Review will stimulate research to determine whether progesterone, with or without estrogen, has a role in reducing cardiovascular risk and treating cardiovascular disease including myocardial ischemia in postmenopausal women.
Potential depot medroxyprogesterone acetate-triggered torsades de pointes in a case of congenital type 2 long QT syndrome.
TLDR
This case report is the first report suggesting a possible association between the synthetic progestin MPA (Depo-Provera) used as a contraceptive and TdP in a woman with congenital type 2 LQTS (LQT2), which stems from mutations in the KCNH2-encoded human ether-a-go-go related gene.
Long QT syndrome and pregnancy.
TLDR
Women with LQTS have a reduced risk for cardiac events during pregnancy, but an increased risk during the 9-month postpartum period, especially among women with the LQT2 genotype.
Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs.
TLDR
It is strongly suggested that women are more prone than men to develop torsades de pointes during administration of cardiovascular drugs that prolong cardiac repolarization.
Drug-induced QT prolongation in women during the menstrual cycle.
TLDR
Menstrual cycle and sex differences exist in QTc responses to ibutilide, with the greatest increase inQTc corresponding to the first half of the menstrual cycle.
Estradiol promotes sudden cardiac death in transgenic long QT type 2 rabbits while progesterone is protective.
TLDR
This study reveals the proarrhythmic effect of EST and the antiarrhythmic effect of PROG in LQT2 in vivo, outlining a new potential antiarrHythmic therapy for LQTS.
Gender disparity in cardiac electrophysiology: implications for cardiac safety pharmacology.
TLDR
The testosterone-mediated increase in repolarization reserve in men is a likely cause for their lower susceptibility to drug-induced TdP, and this is a possible confounding factor in the evaluation and comparison of drugs that has to be further tested.
Progesterone Regulates Cardiac Repolarization Through a Nongenomic Pathway: An In Vitro Patch-Clamp and Computational Modeling Study
TLDR
The data show that progesterone modulates cardiac repolarization by nitric oxide produced via a nongenomic pathway, which provides a framework to understand complex fluctuations of QT interval and torsade de pointes risks in various hormonal states in women.
Progesterone Impairs Human Ether-a-go-go-related Gene (HERG) Trafficking by Disruption of Intracellular Cholesterol Homeostasis*
TLDR
Investigation of the effect of progesterone on the expression, trafficking, and function of HERG channels and the underlying mechanism may reveal a novel molecular mechanism to explain the QT prolongation and high risk of developing arrhythmias during late pregnancy.
Estrogen and Progestin Use and the QT Interval in Postmenopausal Women
TLDR
To determine whether menopausal hormone therapy alters the QT interval in primarily healthy postmenopausal women, a large number of women thought to be eligible for treatment with menopausal hormones are surveyed.