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Torsades de pointes and self‐terminating ventricular fibrillation in a prescription methadone user
Author(s) -
Atkinson D.,
Dunne A.,
Parker M.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05129.x
Subject(s) - torsades de pointes , medicine , ventricular fibrillation , qt interval , anesthesia , methadone , medical prescription , cardiology , long qt syndrome , pharmacology
Summary Methadone is known to prolong the QT interval and precipitate torsades de pointes. A 54‐year‐old prescription methadone user with hypokalaemia was referred to Critical Care with acute confusion and respiratory distress. Alcohol withdrawal was the presumed precipitant. The real precipitant only became evident on analysis of a 24‐h ECG (Holter monitor) attached to the patient at the time. The patient had suffered prolonged (10 min) ventricular arrhythmias including torsades de pointes and self‐terminating ventricular fibrillation. The patient made a full recovery. Risk factors for acquired long QT syndrome and the treatment of torsades de pointes are discussed.