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Review
. 2010 Jan-Feb;107(1):53-8.

Drug-induced QT prolongation and sudden death

Marc E Del Rosario  1 , Richard Weachter, Greg C Flaker
Affiliations
Review

Drug-induced QT prolongation and sudden death

Marc E Del Rosario et al. Mo Med. 2010 Jan-Feb.

Abstract

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.

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Figures

Figure 1
Figure 1
Brief episodes of self-terminating polymorphic ventricular tachycardia were noted after Lidocaine IV bolus was given.
Figure 2
Figure 2
EKG revealed sinus rhythm with no evidence of pre-excitation, no changes consistent with infarction, injury or ischemia, and a QTc of 459 msec.
Figure 3
Figure 3
Drug-induced TdP is usually preceded by a short-long-short ECG sequence.
None
See this image and copyright information in PMC

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