Methadone induced torsades de pointes and ventricular fibrillation: A case review.

Content Provider	Europe PMC
Author	Khalesi, Somayeh Shemirani, Hassan Dehghani-Tafti, Faezeh
Copyright Year	2014
Abstract	BACKGROUNDMethadone is a synthetic opioid, which has been successfully used in treating heroin addiction and chronic pain syndrome in palliative care for more than 30 years. This drug is a potent blocker of the delayed rectifier potassium ion channel, which may result in corrected QT (QTc) interval prolongation and increased risk of torsades de pointes (TdP) in susceptible individuals.CASE REPORTWe describe here a case of methadone-induced TdP that deteriorated into ventricular fibrillation, which was resolved after treatment with IV magnesium, potassium, and Lidocaine. Our purpose in this case review was to highlight the risk of cardiac arrhythmias, in particular QTc interval prolongation leading to TdP in a heroin-dependent patient receiving methadone substitution therapy, and then to present a perspective on treatment and prevention strategies of methadone induced prolonged QTc.CONCLUSIONMethadone-induced TdP is a potentially fatal complication of methadone therapy. As the popularity of methadone use grows, clinicians will encounter more cases of methadone induced TdP, especially in our region, Iran. Hence, a thorough patient history and electrocardiogram monitoring are essential for patients treated with this agent, and alterations in treatment options may be necessary.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4354087&blobtype=pdf
ISSN	17353955
Journal	ARYA Atherosclerosis [ARYA Atheroscler]
Volume Number	10
PubMed Central reference number	PMC4354087
Issue Number	6
PubMed reference number	25815024
e-ISSN	22516638
Language	English
Publisher	Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences
Publisher Date	2014-11-01
Access Restriction	Open
Rights License	This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly. © 2014 Isfahan Cardiovascular Research Center & Isfahan University of Medical Sciences
Subject Keyword	Torsades de Pointes Methadone Ventricular Fibrillation Prolonged Corrected QT
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine