Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2003 Nov;89(11):1363-72.
doi: 10.1136/heart.89.11.1363.

Drug induced QT prolongation and torsades de pointes

Affiliations
Review

Drug induced QT prolongation and torsades de pointes

Yee Guan Yap et al. Heart. 2003 Nov.
No abstract available

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) Self limiting torsades de pointes (TdP). (B) TdP leading to ventricular fibrillation.
Figure 2
Figure 2
Arrhythmogenesis of torsades de pointes. VF, ventricular fibrillation.
Figure 3
Figure 3
Rhythm strip in a patient with drug induced TdP. Note the typical short-long-short initiating ventricular cycle, pause dependent QT prolongation, and abnormal TU wave leading to the classical “twisting of a point” of the cardiac axis during TdP.
Figure 4
Figure 4
Effect of various fluoroquinolones on prolonging action potential duration. Modified and reproduced from Hagiwara and colleagues with permission.
Figure 5
Figure 5
(A) The ECG of a middle aged woman who was otherwise healthy but suffered a ventricular fibrillation cardiac arrest while receiving 20 mg daily of thioridazine. This ECG was recorded immediately after the cardiac arrest. Note the prolonged T wave offset resulting in a prolonged QTc interval of 619 ms. (B) The ECG of the same patient three days after the withdrawal of thioridazine (QTc = 399 ms).

References

    1. De Ponti F, Poluzzi E, Montanaro N, et al. QTc and psychotropic drugs. Lancet 2000;356:75–6. - PubMed
    1. Wysowski DK, Bacsanyi J. Cisapride and fatal arrhythmia. N Engl J Med 1996;335:290–1. - PubMed
    1. Dapro B. Spectrum of drugs prolonging QT interval and the incidence of torsades de pointes. Eur Heart J 2001;3(suppl K):K70–80. ▸ A good review providing an insight into the incidence of drug induced TdP.
    1. Antzelevitch C, Sicouri S. Clinical relevance of cardiac arrhythmias generated by afterdepolarisation: role of M cells in the generation of U wave, triggered activity, and torsades de pointes. J Am Coll Cardiol 1994;23:259–77. ▸ An important study that demonstrated the cellular mechanism of drug induced QT prolongation and TdP. - PubMed
    1. Roden DM. Torsades de pointes. Clin Cardiol 1993;16:683–6. - PubMed

MeSH terms