Humans ; Torsades de Pointes

Although amiodarone is generally regarded as safe with a low incidence of associated arrhythmias, torsade de pointes (TdP) has been observed usually in the presence of predisposing factors. We report a case of amiodarone-induced TdP after long-term administration of a low dose of oral amiodarone in the absence of predisposing factors.
Amiodarone ; Arrhythmias, Cardiac ; Incidence ; Torsades de Pointes

No abstract available.
Magnesium Sulfate* ; Magnesium* ; Torsades de Pointes*

Torsades de pointes (TdP) is a rare complication of a complete atrioventricular block with QT prolongation. Additional risk factors, such as hypokalemia, may increase the risk of TdP during atrioventricular (AV) block. We experienced a case of TdP, caused by a complete heart block and hypokalemia, which was successfully treated by implanting a permanent pacemaker and correction of the electrolyte imbalance.
Atrioventricular Block* ; Heart Block ; Hypokalemia* ; Risk Factors ; Torsades de Pointes*

No abstract available.
Humans ; Long QT Syndrome ; Postoperative Period ; Torsades de Pointes

Electrocardiography ; Female ; Humans ; Syncope/etiology* ; Torsades de Pointes/etiology*

Diagnosis, Differential ; Electrocardiography ; Humans ; Tachycardia, Ventricular ; Torsades de Pointes

Terfenadine is widely used because of nonsedating effect. But It could rarely provoke a potentially lethal ventricular tachyarrhythmia. Recently, we experienced two cases of torsades de pointes(TDP) of occurred after combined use of terfenadine and ketoconazole in usual dose. In one case, 31-yr-old female presented palpitation and recurrent syncope of sudden onset after ingestion of terfenadine 60mg and ketoconzole 200mg 5 times. On attack, ECG showed a polymorphic ventricular tachycardia, and after attack, showed prolongation of QT interval and TU wave changes. Her laboratory findings were not contributory. TDP was controlled with MgSO4 and isoproterenol infusion. Then, QT interval was normalized and no further episode occurred. In the other case, 32-yr-old female presented palpitation and recurrent syncope of sudden onset after ingestion of terfenadine 60mg and ketoconzole 200mg 5 times. ECG showed prolongation of QT interval and TU wave changes. Her laboratory findings were not contributory. TDP was controlled with MgSO4 and isoproterenol infusion. Then, QT interval was normalized and no further episode occurred.
Eating ; Electrocardiography ; Female ; Humans ; Isoproterenol ; Ketoconazole* ; Syncope ; Tachycardia ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

While some fluoroquinolone antibiotics can cause QT prolongation and Torsades de Pointes (TdP), serious proarrhythmic effects from ofloxacin have not been reported. Here, we report a case of ofloxacin-induced Torsades de Pointes with abnormal ECG changes, mimicking acute myocardial infarction. A 68-year-old man developed syncope following hospital admission for the treatment of pulmonary tuberculosis. TdP and marked QT prolongation (QT=0.44 sec, QTc=0.62 sec) were noted, with no remarkable serum electrolyte abnormality. The QT prolongation was followed by ST segment elevation, mimicking acute myocardial infarction. After discontinuation of ofloxacin, the QT interval shortened to 0.336 sec (QTc=0.481 sec), with no recurrence of TdP, although the QT interval remained mildly elevated during the hospital course. From this case, we propose that care should be taken in the use of ofloxacin, especially in patients susceptible to TdP.
Aged ; Anti-Bacterial Agents ; Electrocardiography* ; Humans ; Myocardial Infarction* ; Ofloxacin ; Recurrence ; Syncope ; Torsades de Pointes* ; Tuberculosis, Pulmonary

BACKGROUND: Methadone is a synthetic opioid that is widely used for the treatment of chronic pain. The association between methadone treatment and QT interval prolongation or which can lead to torsades de pointes has been confirmed with larger studies on high dose methadone. The aim of this study was to determine the effect of methadone on the QTc interval in patients, whether the daily dose of methadone should be lower than what has been previously investigated. METHODS: A total of 130 patients were included, with 90 patients in the methadone group and 40 patients in the control group. For each ECG, heart rate, QT interval and corrected QT (QTc) interval were recorded. The patient demographics, methadone dose and serum level, duration of methadone use and past medical history were collected. RESULTS: The QTc interval was significantly longer in the treatment group than in the control group (443 +/- 30.0 ms versus 408 +/- 28.0 ms, respectively, P < 0.0001) and more patients in the treatment group had a QTc interval greater than 450 ms (36.7% versus 7.5%, respectively, P = 0.0005). The QTc interval was not associated with methadone dose P = 0.9278), serum level (P = 0.2256) or duration of treatment (P = 0.1822). CONCLUSIONS: This study has shown that methadone use is associated with longer QTc intervals, even among patients with daily doses of less than 80 mg. In this study, no correlation was found between QTc duration and methadone dose, serum levels or duration of use. However, the magnitude of the QTc interval was associated with female gender and the use of antidepressants.
Antidepressive Agents ; Chronic Pain ; Demography ; Electrocardiography ; Female ; Heart Rate ; Humans ; Methadone ; Retrospective Studies ; Torsades de Pointes