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[Prolongation of the QT interval and torsade de pointes caused by ketanserin]
S Arfiero1, R Ometto, M Vincenzi
1Divisione clinicizzata di Cardiologia, Ospedale S. Bortolo, Vicenza, Università di Verona.
Insights
Ketanserin treatment in an 84-year-old man with hypertension caused significant QT interval prolongation and fainting spells. Drug withdrawal and re-administration confirmed ketanserin
Area of Science:
- Cardiology
- Clinical Pharmacology
Background:
- Aortic valvular disease and arterial hypertension are common comorbidities.
- Drug-induced QT prolongation is a serious adverse event.
Observation:
- An 84-year-old male patient developed syncope and marked QT prolongation after 3 months of ketanserin therapy.
- Continuous ECG monitoring was performed during drug withdrawal and re-administration.
Findings:
- Ketanserin treatment was strongly correlated with QT interval prolongation.
- Symptomatic torsade de pointes ventricular tachycardia occurred during ECG monitoring.
- Drug withdrawal led to symptom resolution, while re-administration reproduced the adverse events.
Implications:
- Careful patient selection is crucial for initiating ketanserin treatment.
- Regular ECG monitoring is recommended for patients on ketanserin.
- The study highlights the potential cardiotoxic effects of ketanserin, necessitating cautious use.
Abstract:
The authors report the case of an 84-year-old man with mild aortic valvular disease and arterial hypertension who developed marked QT interval prolongation and several lipotimic and syncopal attacks after 3 months of treatment with ketanserin (40 mg/day). The correlation between ketanserin, QT prolongation and symptoms was assessed by withdrawal and subsequent re-administration of the drug. Continuous ECG monitoring revealed the occurrence of QT prolongation and symptomatic runs of torsade de pointes ventricular tachycardia. The Authors suggest that treatment with ketanserin needs careful patients selection and follow-up.