EDUCATION IN HEART

Electrophysiology

Drug induced QT prolongation and torsades de pointes

Yee Guan Yap, A John Camm

Department of Cardiological Sciences, St George’s Hospital Medical School, London, UK

Correspondence to:
Correspondence to:
Dr Yee Guan Yap
Department of Cardiological Sciences, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK; ygyap@aol.com

Keywords: Torsades de pointes; drug induced QT prolongation; antiarrhythmics; antihistamines; antimicrobials; antidepressants

The first 150 words of the full text of this article appear below.

In 1966, Francois Dessertenne described a specific electrocardiographic form of polymorphic ventricular tachycardia, which he termed "torsades de pointes" (TdP).^{w1 w2} The word "torsades" refers to an ornamental motif imitating twisted hairs or threads as seen on classical architectural columns, and "pointes" referred to points or peaks.^{w1 w2} In the seminal article, Dessertenne made no attempt to suggest the mechanism of TdP and, until recently, there has been considerable conjecture as to the pathophysiology of this arrhythmia.

CAUSES OF TORSADES DE POINTES

Since the original work by Dessertenne, it has been well recognised that many conditions may cause prolonged or abnormal repolarisation (that is, QT interval prolongation and/or abnormal T or T/U wave morphology), which is associated with TdP. If TdP is rapid or prolonged, it can lead to ventricular fibrillation and sudden cardiac death (fig 1). Essentially, TdP may be caused by either congenital or acquired long QT syndrome (LQTS). In recent years, there . . . [Full text of this article]

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