Drug Induced Long QT
Abstract
A 54 years old cattle-farm owner was found un-conscious by his daughter at his living room. After she repeatedly shook his body, he regained consciousness without any impairment. He told his daughter that before collapse he suddenly felt weakness all over his body, a bit lightheaded and a brief period of palpitation. On the next day he experienced the same symptom, and this time he fainted at the farm. He was rushed to 24-hour infirmary, but he recovered before reaching the clinic. He afterwards was seen by a doctor and was told to have a mild stroke. He was referred to emergency department at a nearby hospital where he passed out for the third time; but this time was witnessed by his daughter. She noted that before he fell down, he was having a short period of seizure.A neurologist was among the first physician who saw him and noticed that the patient had a very slow pulse. He accordingly consulted the patient to cardiologist due to bradycardia.
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References
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Haverkamp W, Eckardt L, Monnig G. Clinical aspects of ventricular arrhythmias associated with QT prolongation. Eur Heart J2001;3:K81-8.
Hanno LT, Charles JY, Michael RL, Ruey JS. Electrophysiologic mechanisms of the long QT interval syndromes and torsade de pointes. Ann Intern Med1995;122:701-714
Darpo B. Spectrum of drugs prolonging QT interval and the incidence of torsades de points. Eur Heart J2001;3:K70-80.
Bauman JL. The role of pharmacokinetics, drug interactions and pharmacogenetics in the acquired long QT syndrome. Eur Heart J2001;3:K93-100.
Monahan BP, Ferguson CL, Killeavy ES, Lloyd BK, Troy J, Cantilena LR. Torsades de pointes occurring in association with terfenadine use. JAMA1990;264:2788-90.
McConnel TJ, Stanner AJ. Torsades de pointes complicating treatment with terfenadine. BMJ1991;302:1469.
Woosley RL, Chen Y, Freiman JP, Gilles RA.Mechanism of the cardiotoxic actions of terfenadine. JAMA1993;269:1532–6.
Zimmermann M, Duruz H, Guinand O, et al. Torsades de pointes after treatment with terfenadine and ketoconazole. Eur Heart J1992;13:1002-3.
Honig PK, Wortham DC, Zamani K, Conner DP, Mullin JC, Cantilena LR. Terfenadine-ketoconazole interaction: pharmacokinetic and electrocardiographic consequences. JAMA 1993;269:1513-1518.
Yap YG, Camm J. Risk of torsades de pointes with non-cardiac drugs. BMJ2000;3 20; 1158-1159.
Priori SG, Schwartz PJ, Napolitano C, et al. Risk stratification in the long-QT syndrome. N Engl J Med2003;348:1866-1874.
Roden DM. Drug-induced prolongation of QT interval. N Engl J Med2004:350;1013-1022.
Haverkamp W, Breithardt G, Camm J. The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Eur Heart J2000;21:1216-31.
Cavuto NJ, Woosley RL, Sale M. Pharmacies and prevention of potentially fatal drug interactions. JAMA2006;275:1086-1087.
Burkhart GA, Sevka MJ, Temple R, Honig PK. Temporal decline in filling prescriptions for terfenadine closely in time with those for either ketoconazole or erythromycin. Clin Pharmacol Ther 1997;61:93-96 [abstract]
Haverkamp W, Eckardt L, Monnig G. Clinical aspects of ventricular arrhythmias associated with QT prolongation. Eur Heart J2001;3:K81-8.
Hanno LT, Charles JY, Michael RL, Ruey JS. Electrophysiologic mechanisms of the long QT interval syndromes and torsade de pointes. Ann Intern Med1995;122:701-714
Darpo B. Spectrum of drugs prolonging QT interval and the incidence of torsades de points. Eur Heart J2001;3:K70-80.
Bauman JL. The role of pharmacokinetics, drug interactions and pharmacogenetics in the acquired long QT syndrome. Eur Heart J2001;3:K93-100.
Monahan BP, Ferguson CL, Killeavy ES, Lloyd BK, Troy J, Cantilena LR. Torsades de pointes occurring in association with terfenadine use. JAMA1990;264:2788-90.
McConnel TJ, Stanner AJ. Torsades de pointes complicating treatment with terfenadine. BMJ1991;302:1469.
Woosley RL, Chen Y, Freiman JP, Gilles RA.Mechanism of the cardiotoxic actions of terfenadine. JAMA1993;269:1532–6.
Zimmermann M, Duruz H, Guinand O, et al. Torsades de pointes after treatment with terfenadine and ketoconazole. Eur Heart J1992;13:1002-3.
Honig PK, Wortham DC, Zamani K, Conner DP, Mullin JC, Cantilena LR. Terfenadine-ketoconazole interaction: pharmacokinetic and electrocardiographic consequences. JAMA 1993;269:1513-1518.
Yap YG, Camm J. Risk of torsades de pointes with non-cardiac drugs. BMJ2000;3 20; 1158-1159.
Priori SG, Schwartz PJ, Napolitano C, et al. Risk stratification in the long-QT syndrome. N Engl J Med2003;348:1866-1874.
Roden DM. Drug-induced prolongation of QT interval. N Engl J Med2004:350;1013-1022.
Haverkamp W, Breithardt G, Camm J. The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Eur Heart J2000;21:1216-31.
Cavuto NJ, Woosley RL, Sale M. Pharmacies and prevention of potentially fatal drug interactions. JAMA2006;275:1086-1087.
Burkhart GA, Sevka MJ, Temple R, Honig PK. Temporal decline in filling prescriptions for terfenadine closely in time with those for either ketoconazole or erythromycin. Clin Pharmacol Ther 1997;61:93-96 [abstract]
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How to Cite
Martha, J. (1). Drug Induced Long QT. Indonesian Journal of Cardiology, 29(1), 25-31. https://doi.org/10.30701/ijc.v29i1.199
Section
Case Reports
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