Life-threatening adverse drug reactions causing - QT prolongation
Description
- Drug-induced prolongation of ventricular repolarisation -> acquired long QT -> torsades de pointes (TdP) -> VF and sudden cardiac death
- TdP = polymorphic VT with a continuously varying axis ("twisting of the points") on a background of a long QT
- Usually pause-dependent: initiated by a short-long-short RR sequence
- Most episodes are self-terminating -> syncope; a minority degenerate to VF
- *QT prolongation is a surrogate marker, not the disease - risk is multiplicative across drug, electrolyte and patient factors*
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