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Drug-Induced QT Prolongation

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Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care

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Abstract

Abnormal cardiac repolarization, as indicated by prolongation of the QT interval on the standard electrocardiogram, is a risk factor for malignant dysrhythmias such as torsades de pointes. QT prolongation in the perioperative setting is both common and likely underreported, as a minority of patients are monitored on telemetry in the perioperative period. Though QT prolongation may be congenital, the majority of cases seen in the perioperative setting are drug induced. Many different classes of drugs have been shown to prolong the QT interval, and the administration of multiple QT-prolonging medications may have an additive effect. It is imperative that the clinician be aware of which drugs commonly used in the perioperative setting may cause QT prolongation as well as the unique treatments for management of torsades de pointes beyond standard resuscitative measures.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA

    Elizabeth A. Valentine MD

  2. Department of Anesthesiology, Tulane Medical Center, New Orleans, LA, USA

    Alan David Kaye MD, PhD

  3. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Alan David Kaye MD, PhD

  4. Department of Anesthesiology, Alton Ochsner Clinic, New Orleans, LA, USA

    Jackie V. Abadie MD

  5. Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, 3601 Pacific Avenue, Stockton, CA, USA

    Adam M. Kaye PharmD

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  1. Elizabeth A. Valentine MD
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  2. Alan David Kaye MD, PhD
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  3. Jackie V. Abadie MD
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Correspondence to Elizabeth A. Valentine MD .

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Editors and Affiliations

  1. Departments of Anesthesiology and Pharmacology, LSU Health Sciences Center, New Orleans, Louisiana, USA

    Alan David Kaye

  2. Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, Stockton, California, USA

    Adam M. Kaye

  3. Center for Perioperative Management and Medical Informatics, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Richard D. Urman

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Valentine, E.A., Kaye, A.D., Abadie, J.V., Kaye, A.M. (2015). Drug-Induced QT Prolongation. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8948-1_46

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