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Volume 350:2618-2621 June 17, 2004 Number 25
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Drug-Induced Prolongation of the QT Interval

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by Roden, D. M.
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To the Editor: Roden (March 4 issue)1 provides a concise review of drug-induced prolongation of the QT interval. However, in Table 2 of the article, which lists risk factors for torsade de pointes, diet and fasting are not mentioned. There have been several reports of prolongation of the QT interval and associated torsade de pointes resulting from protein-sparing diets, starvation, anorexia nervosa, and fasting during a hunger strike.2,3,4,5 Consequently, physicians should pay particular attention whenever prescribing QT-interval–prolonging drugs in patients in such circumstances.


Panagiotis Korantzopoulos, M.D.
Konstantinos Siogas, M.D.
G. Hatzikosta General Hospital of Ioannina
45001 Ioannina, Greece
pkor@oneway.gr

  1. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med 2004;350:1013-1022. [Free Full Text]
  2. Khan IA. Clinical and therapeutic aspects of congenital and acquired long QT syndrome. Am J Med 2002;112:58-66. [CrossRef][ISI][Medline]
  3. Ahmed W, Flynn MA, Alpert MA. Cardiovascular complications of weight reduction diets. Am J Med Sci 2001;321:280-284. [CrossRef][ISI][Medline]
  4. Swenne I, Larsson PT. Heart risk associated with weight loss in anorexia nervosa and eating disorders: risk factors for QTc interval prolongation and dispersion. Acta Paediatr 1999;88:304-309. [CrossRef][ISI][Medline]
  5. Altun G, Ugur-Altun B, Altun A, Azmak D. Sudden cardiac death in a hunger strike. Cardiology 2003;100:107-108. [Medline]
 
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