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Case Reports
. 2007 Sep;23(11):907-8.
doi: 10.1016/s0828-282x(07)70850-4.

Torsade de pointes associated with moxifloxacin: a rare but potentially fatal adverse event

T Altin  1 , O Ozcan, S Turhan, A Ongun Ozdemir, O Akyurek, R Karaoguz, M Guldal
Affiliations
Case Reports

Torsade de pointes associated with moxifloxacin: a rare but potentially fatal adverse event

T Altin et al. Can J Cardiol. 2007 Sep.

Abstract
in English, French

Torsade de pointes occuring due to a long QT interval is a rare but potentially fatal arrhythmia. Acquired long QT develops most commonly because of drugs that prolong ventricular repolarization. It has been reported that fluoroquinolone antimicrobials prolong the corrected QT interval but rarely cause torsade de pointes. A patient with torsade de pointes risk factors (female sex, advanced age, extreme bradycardia and renal failure) who developed the condition on the fourth day of 400 mg/day of oral moxifloxacin treatment is presented. After the moxifloxacin was stopped, the corrected QT interval normalized and a permanent cardiac pacemaker was implanted. During 11 months of follow-up, arrhythmia did not recur.

Les torsades de pointe attribuables à un intervalle QT long sont des arythmies rares, mais au potentiel fatal. D’ordinaire, les intervalles QT longs se manifestent en raison de médicaments qui prolongent la repolarisation ventriculaire. Il a été signalé que les fluoroquinolones, un antimicrobien, prolongent l’intervalle QT corrigé mais sont rarement responsables de torsades de pointe. On présente le cas d’une patiente ayant des facteurs de risque de torsades de pointe (sexe féminin, âge avancé, bradycardie extrême et insuffisance rénale) qui a souffert de ce trouble après avoir suivi un traitement de 400 mg/jour de moxiflocacine par voie orale pendant quatre jours. Après l’abandon de la moxifloxacine, l’intervalle QT corrigé s’est normalisé, et on a implanté à la patiente un stimulateur cardiaque permanent. L’arythmie ne s’est pas manifestée de nouveau au cours des 11 mois de suivi.

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Figures

Figure 1)
Figure 1)
The electrocardiogram of the patient at admission. A junctional rhythm with a rate of 30 beats/min is seen. The QT interval was 0.66 s and the corrected QT interval was 0.47 s (the paper speed was 25 mm/s)
Figure 2)
Figure 2)
Telemetry record showing torsade de pointes that terminated spontaneously after 36 s. A short-long-short sequence preceded the arrhythmia (the paper speed was 25 mm/s)
See this image and copyright information in PMC

References

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