Persistent Atrial Fibrillation Is Associated With Reduced Risk of Torsades de Pointes in Patients With Drug-Induced Long QT Syndrome
Dawood Darbar, MD, FACC*,*,
John Kimbrough, MD, PhD*,
Asif Jawaid*,
Robert McCray, MD ,
Marylyn D. Ritchie, PhD and
Dan M. Roden, MD, FACC*,
* Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee
Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee.
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Figure 1 A 12-Lead ECG Taken in a Patient 2 Days After Commencing Quinidine for AF
The longest QT interval was measured at 700 ms in lead III. AF = atrial fibrillation; ECG = electrocardiogram.
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Figure 2 ECG From a Patient Started on Sotalol
(Top) During AF, there is irregularity of ventricular response creating frequent short-long-short cycles, but there is minimal change in QT intervals. (Middle) After direct current cardioversion, the QT interval has increased dramatically to 640 ms and (bottom) an episode of torsades de pointes is triggered. Abbreviations as in Figure 1.
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