A case series of drug-induced long QT syndrome and Torsade de Pointes.

摘要: Introduction Torsade de Pointes (Tdp) is a form of polymorphic ventricular tachycardia in the setting prolonged QT interval. Any drug that prolongs repolarisation, and hence interval, may cause Tdp. Predisposing factors drug-induced Tdp include female sex, bradyarrhythmia hypokalaemia. Methods We retrospectively analysed case notes 13 patients with LQTS from 1991 to 2000 National Heart Centre Changi General Hospital. Results Causative drugs series were amiodarone (seven patients, 54%), sotalol (two patients), quinidine (one patient), phenothiazine patients) astemizole patient). There eight females all Chinese. The mean age was 72 +/- nine years. commonly present syncope (38%) cardiac arrest (38%). corrected QTC interval 545 ms. most common precipitating factor hypokalaemia (31%). Nine require cardiopulmonary resuscitation two (15%) died. (69%) had underlying structural heart disease such as ischaemic disease, valvular hypertensive disease. left ejection fraction normal six patients. onset ranged Day 2 5 seven patient amiodarone-induced LQTS. These inpatients who given intravenous loading doses amiodarone. Both sotalol-induced on 80 mg 240 per day occurring 10 months respectively. Conclusion potentially life-threatening arrhythmia. list torsadogenic ever expanding. Physicians need know which can lead Careful assessment risk-benefit ratio important before prescribing drugs. Amiodarone-induced not uncommon our local population. Initiation class III agent, especially amiodarone, should be done judiciously, monitoring avoidance