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Inicio Medicina Clínica (English Edition) Drug-induced QT interval prolongation: Do we know the risks?
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Vol. 144. Issue 6.
Pages 269-274 (March 2015)
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Vol. 144. Issue 6.
Pages 269-274 (March 2015)
Review
Drug-induced QT interval prolongation: Do we know the risks?
Prolongación del intervalo QT inducido por fármacos: ¿conocemos sus riesgos?
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Elena Villamañána,
Corresponding author
evillabueno@telefonica.net

Corresponding author.
, Eduardo Armadab, Margarita Ruanoa
a Servicio de Farmacia, Hospital Universitario La Paz, Madrid, Spain
b Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
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Tables (6)
Table 1. Drugs that may prolong the QT interval.
Table 2. Risk factors of torsade de pointes induced by drugs.
Table 3. Pharmacokinetic interactions of drugs that prolong the QT interval.
Table 4. Drugs that cause bradycardia.
Table 5. Hypokalaemia-causing drugs.
Table 6. Recommendations for the prevention of torsade de pointes caused by drugs.
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Abstract

Sudden cardiac death is an important cause of mortality in developed countries, most of them being consequence of acute ventricular arrhythmias. These arrhythmias, in some cases, owe to QT interval prolongation.

A major risk factor for this condition is the use of drugs that prolong the QT interval. In fact, in recent years, one of the most common reasons for drug withdrawal or usage restrictions has been drug induced QT interval prolongation that involves both cardiovascular and non-cardiovascular drugs.

Taking into account the severity that the occurrence of such an event may have, it is important for clinicians to know the risks of these drugs in certain patients. In this review we analyse the drugs that prolong the QT interval, the risk factors that can enhance QT prolongation and the drug interactions that can increase these risks.

Keywords:
QT interval prolongation
Torsade de pointes
Drugs
Risk factors
Drug interactions
Resumen

La muerte súbita cardiaca es una causa importante de mortalidad en los países desarrollados. La mayoría de ellas derivan de arritmias ventriculares agudas que, en algunas ocasiones, se producen como consecuencia de la prolongación del intervalo QT.

Un importante factor de riesgo para esta alteración es el uso de fármacos que prolongan este intervalo. De hecho, en los últimos años, uno de los motivos más frecuentes de retirada del mercado de medicamentos o de restricciones de uso ha sido la prolongación del intervalo QT, e implica tanto fármacos cardiovasculares como no cardiovasculares.

Dada la gravedad que puede conllevar la aparición de un suceso por esta causa, es importante que los clínicos conozcan los riegos del uso de estos fármacos en determinados pacientes. En esta revisión analizamos los fármacos que prolongan el intervalo QT, los factores de riesgo que pueden influir y las combinaciones de fármacos que pueden agravar esta situación.

Palabras clave:
Prolongación del intervalo QT
Torsade de pointes
Fármacos
Factores de riesgo
Interacciones farmacológicas

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