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Management of Cardiac Arrhythmias pp 463–477Cite as

Acquired Long QT Syndrome and Torsades de Pointes

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Acquired long QT syndrome is an arrhythmogenic syndrome which is associated with life-threatening ventricular tachyarrhythmias termed as torsades de pointes and sudden death as the consequence of QT prolongation after exposure to secondary factors, e.g., drugs; electrolyte abnormalities including hypokalemia, hypomagnesemia, or hypocalcemia; and marked bradycardia. The clinical findings of QT prolongation on electrocardiogram (ECG) and torsades de pointes have been considered to appear unexpectedly after exposure to secondary factors. Prolonged QT interval generally becomes normalized after removal of secondary factors, although the QT interval may sometimes remain mildly prolonged even without secondary factors. We need to take account of a latent genetic background that plays a role in this syndrome because significant QT prolongation could be revealed only in some of patients who have been exposed to the same secondary factors. When we manage those with a potential risk for such a syndrome, we should not miss any subtle alert from patients in the presence of secondary factors. What we have to keep in mind is that keeping alert for this syndrome is critically important not only to cardiologists but also to all of other physicians for the prevention of unexpected sudden.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan

    Hideki Itoh

  2. Division of Patient Safety, Hiroshima University Hospital, Hiroshima, Japan

    Hideki Itoh

  3. Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan

    Wataru Shimizu

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  1. Hideki Itoh
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  2. Wataru Shimizu
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Correspondence to Hideki Itoh or Wataru Shimizu .

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Editors and Affiliations

  1. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Gan-Xin Yan

  2. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Peter R. Kowey

  3. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Charles Antzelevitch

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Itoh, H., Shimizu, W. (2020). Acquired Long QT Syndrome and Torsades de Pointes. In: Yan, GX., Kowey, P., Antzelevitch, C. (eds) Management of Cardiac Arrhythmias. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-030-41967-7_20

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  • DOI: https://doi.org/10.1007/978-3-030-41967-7_20

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  • Publisher Name: Humana, Cham

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