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Case Reports
. 2006 Nov;21(11):C9-C12.
doi: 10.1111/j.1525-1497.2006.00588.x.

A twist on torsade: a prolonged QT interval on methadone

Patricia Lamont  1 , Susan C Hunt
Affiliations
Case Reports

A twist on torsade: a prolonged QT interval on methadone

Patricia Lamont et al. J Gen Intern Med. 2006 Nov.

Abstract

A woman developed a prolonged QT interval and torsade de pointes while on methadone treatment for heroin addiction. We think methadone, or its impaired metabolism, was the major cause for her prolonged QT interval and progression to torsade. However, torsade is often multifactorial, as was likely so in this case. We advise physicians treating patients taking methadone to obtain careful medication and drug-use histories, screen for risk factors associated with long QT syndrome, counsel patients about potential drug interactions, and measure the QT interval before and during methadone treatment in high-risk patients.

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Figures

FIGURE 1
FIGURE 1
Electrocardiogram obtained during initial evaluation. Note the prolonged QTc interval of 618 ms (normal QTc is <460 ms).
FIGURE 2
FIGURE 2
Rhythm strip demonstrating torsade de pointes.
FIGURE 3
FIGURE 3
Electrocardiogram after a dose reduction in methadone. Note the normal QTc of 365 ms (normal QTc is <460 ms).
See this image and copyright information in PMC

References

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