QTc prolongation in methadone maintenance--the role of HCV infection

Abstract

Objectives: Several studies have reported prolonged QTc intervals in patients under methadone maintenance treatment, including development of torsade-de-pointes arrhythmia and death. It is still not clear why some patients develop critical QTc extensions while others do not.

Methods: ECG findings in a convenience sample of 210 methadone-maintained heroin-dependent patients, taking HCV-infection status and methadone dosage into account simultaneously by means of a multiple linear regression model with QTc-interval as the dependent variable.

Results: Prolonged QTc-time is associated with hepatitis C infections (p = 0.005) and higher doses of racemic methadone (p = 0.012).

Conclusion: Infection with hepatitis C increases the likelihood of critical QTc prolongation in patients in methadone maintenance treatment.