title: Acquired prolongation of QT interval as a risk factor for torsade de pointes ventricular tachycardia: a narrative review for the anesthesiologist and intensivist.
abstract: More than 70% of intensive care unit (ICU) patients experience heart rhythm disturbances, and these patients have correspondingly higher mortality rates. Consequently, one of the standards of care in ICUs is continuous electrocardiography monitoring. One of the potentially preventable dysrhythmic events is the occurrence of torsade de pointes ventricular tachycardia in the setting of acquired prolonged QT interval. This type of ventricular tachycardia can be malignant because it often progresses to ventricular fibrillation. Many factors predispose to lengthening of the QT interval, the most important of which are electrolyte abnormalities and the administration of specific medications. In this review, we discuss the pathophysiology of acquired long QT interval, stressing the medication-induced acquired long QT-interval and factors present in ICU patients that promote prolongation of the QT interval. We also propose guidelines to avoid the occurrence of torsade de pointes ventricular tachycardia.
authors.affiliation: Department of Anesthesia and Intensive care, Emergency Center, Clinical Center of Vojvodina, Hajduk Veljkova 1-10, Novi Sad, 21000, Serbia. arsenuvelin@gmail.com.|Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia. arsenuvelin@gmail.com.
authors.forename: Arsen
authors.initials: A
authors.lastname: Uvelin
authors.affiliation: Department of Anesthesia and Intensive care, Emergency Center, Clinical Center of Vojvodina, Hajduk Veljkova 1-10, Novi Sad, 21000, Serbia.
authors.forename: Jasmina
authors.initials: J
authors.lastname: Pejaković
authors.affiliation: Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Mijatović
mesh_terms: D000072080:Anesthesiologists; D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D004562:Electrocardiography; D006801:Humans; D008133:Long QT Syndrome / Q000150:complications*; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000150:complications / Q000517:prevention & control*; D016171:Torsades de Pointes / Q000209:etiology / Q000517:prevention & control*; D014693:Ventricular Fibrillation / Q000517:prevention & control
keywords: Acquired; Critically ill patients; Medication-induced QT interval prolongation; QT interval prolongation; Torsade de pointes ventricular tachycardia