Drug-induced QT prolongation and sudden death.
Prolongation of the QT interval can predispose to a potentially fatal polymorphic ventricular tachycardia called torsades de pointes (TdP). Although usually self-limited, TdP may degenerate into ventricular fibrillation and cause sudden death. Some medications that cause QT prolongation and possible TdP are commonly used in general practice. This paper presents a case of sudden death that is likely from drug-induced TdP. It reviews the mechanisms, risk factors, offending agents, and management of drug-induced torsades de pointes.
Del Rosario
Marc E
ME
University of Missouri Hospital and Clinics, Division of Cardiovascular Medicine, USA.
Weachter
Richard
R
Flaker
Greg C
GC
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D017963:Azithromycin / Q000009:adverse effects; D003000:Clonidine / Q000009:adverse effects / Q000031:analogs & derivatives; D016757:Death, Sudden, Cardiac; D004347:Drug Interactions; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D012307:Risk Factors; D016171:Torsades de Pointes / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D014150:Antipsychotic Agents; C023754:tizanidine; D017963:Azithromycin; D003000:Clonidine