Drug-Induced Prolongation of the QT Interval

doi:10.1056/NEJMra032426

Volume 350:1013-1022		March 4, 2004		Number 10

Drug-Induced Prolongation of the QT Interval

Dan M. Roden, M.D.

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In the past decade, the single most common cause of the withdrawalor restriction of the use of drugs that have already been marketedhas been the prolongation of the QT interval associated withpolymorphic ventricular tachycardia, or torsade de pointes (Figure 1),which can be fatal.¹ Nine structurally unrelated drugs thatwere marketed in the United States or elsewhere for a rangeof noncardiovascular indications have been removed from themarket or had their availability severely restricted becauseof this rare form of toxicity. These drugs are terfenadine,astemizole, grepafloxicin, terodiline, droperidol, lidoflazine,sertindole, levomethadyl, and cisapride.

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Figure 1. . . . [Full Text of this Article]

The Clinical Background of Long-QT Syndrome

Problems Posed by Technological and Scientific Advances

Measurement and Interpretation of the QT Interval

Basic Electrophysiological Mechanisms

Identification of Drugs That Cause Torsade de Pointes

Weighing Risks and Benefits

Decision Making and Drugs with QT-Interval–Prolonging Potential

Broader Implications

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From the Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville.

Address reprint requests to Dr. Roden at the Division of Clinical Pharmacology, Vanderbilt University School of Medicine, 532 Medical Research Bldg. I, Nashville, TN 37232, or at dan.roden@vanderbilt.edu.

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Drug-Induced Prolongation of the QT Interval
Korantzopoulos P., Siogas K., Viskin S., Justo D., Zeltser D., Curigliano G., Cipolla C., de Braud F., Cruciani R. A., Portenoy R. K., Homel P., Roden D. M.
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N Engl J Med 2004; 350:2618-2621, Jun 17, 2004. Correspondence

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