Review
Copyright ©2013 Baishideng Publishing Group Co.
World J Cardiol. Apr 26, 2013; 5(4): 87-93
Published online Apr 26, 2013. doi: 10.4330/wjc.v5.i4.87
Table 1 Drugs that prolong the QT interval and/or induce torsades de pointes
Drugs to be avoided in patients with c-long QT syndrome
Class
Generic name
AnestheticSevoflurane
Anti-anginalRanolazine, Bepridil
Anti-arrhythmicSotalol, Quinidine, Amiodarone, Ibutilide, Disopyramide, Procainamide, Flecainide, Dofetilide, Dronedarone
AntibioticMoxifloxacin, Clarithromycin, Ciprofloxacin, Gemifloxacin, Ofloxacin Telithromycin, Levofloxacin, Roxithromycin, Trimethoprim-Sulfa, Gatifloxacin, Sparfloxacin, Azithromycin Erythromycin
Anti-cancerTamoxifen, Lapatinib, Nilotinib, Arsenic trioxide, Eribulin, Sunitinib
Vandetanib
Anti-convulsivantFosphenytoin, Felbamate
Anti-depressantMirtazapine, Citalopram, Venlafaxine, Paroxetine, Fluoxetine, Sertraline, Trazodone, Escitalopram, Clomipramine, Amitriptyline, Imipramine, Nortriptyline, Desipramine, Doxepin, Trimipramine, Protriptyline
Anti-fungalVoriconazole, Fluconazole, Ketoconazole, Itraconazole
AntihistamineAstemizole, Terfenadine, Diphenhydramine, Diphenhydramine
Anti-hypertensiveNicardipine, Isradipine, Moexipril/HCTZ
Anti-infectivePentamidine
AntilipemicProbucol
Anti-malarialArtenimol + piperaquine, Chloroquine, Halofantrine
Anti-maniaLithium
Anti-nausea/antiemeticGranisetron, Dolasetron, Ondansetron
Anti-psychoticClozapine, Ziprasidone, Thioridazine, Risperidone, Mesoridazine, Quetiapine, Haloperidol, Pimozide, Amisulpride, Sertindole, Sertindole, Iloperidone, Paliperidone, Chlorpromazine
Anti-viralFoscarnet, Ritonavir, Atazanavir
Appetite suppressantPhentermine, Fenfluramine, Sibutramine
Bladder AntispasmodicTolterodine
α1-blockerAlfuzosin
Bronchodilator/decongestantAlbuterol, Salmeterol, Metaproterenol, Terbutaline, Metaproterenol, Levalbuterol, Ephedrine, Phenylpropanolamine, Pseudoephedrine
Cholinesterase inhibitorGalantamine
CNS stimulantAmphetamine
Methylphenidate
Amphetamine
Dexmethylphenidate
Methylphenidate
Lisdexamfetamine
DiureticIndapamide
Dopaminergic/anti-viral/anti-infective/Amantadine
EndocrineOcreotide
GI stimulantCisapride
H2-receptor antagonistFamotidine
Imaging contrast agentPerflutren lipid microspheres
ImmunosuppressantTacrolimus, Fingolimod
Inotropic agent/vasconstrictorDopamine, Isoproterenol, Dobutamine, Epinephrine, Norepinephrine, Phenylephrine
Local anestheticCocaine
Muscarinic receptor anatagonistSolifenacin
Muscle relaxantTizanidine
norepinephrine reuptake inhibitorAtomoxetine
Opiate agonistMethadone, Levomethadyl
OxytocicOxytocin
phosphodiesterase inhibitor/vasodilatorVardenafil
SedativeChloral hydrate
Sedative; Anti-nausea/anesthesia adjunctDroperidol
Uterine relaxantRitodrine
VasconstrictorMidodrine
Table 2 Normal QT corrected using the Bazzet’s formula duration by age and gender
QT corrected using the Bazzet’s formula
QTc value (s)
Children (1-15 yr)
Male ( > 15 yr)
Female ( > 15 yr)
Normal< 0.44< 0.43< 0.45
Borderline0.44-0.460.43-0.450.45-0.46
Prolonged> 0.46> 0.45> 0.46
Table 3 Electrocardiograph pattern in long QT syndrome
ECG in LQTS
LQT1Prolonged QT, T wave normal or with increased amplitude with a wide base
LQT2Prolonged QT, T wave with low amplitude and often bifid
LQT3Late onset of the T wave, prolonged isoelectric segment