Tatetsu Hiro, Asou Norio, Nakamura Miki, Hanaoka Nobuyoshi, Matsuno Fumihiko, Horikawa Kentaro, Mitsuya Hiroaki
Department of Hematology, Kumamoto University School of Medicine, Kumamoto, Japan.
Am J Hematol. 2006 May;81(5):366-9. doi: 10.1002/ajh.20557.
Prolonged QT syndrome often causes torsades de pointes (Tdp), a potentially lethal arrhythmia. A 55-year-old woman with M4Eo who was receiving consolidation chemotherapy had an episode of prolonged QT and Tdp following fluconazole (FCZ) administration. Intravenous supplementation of magnesium sulfate and multiple attempts at electrocardioversion led to recovery from the arrhythmia. FCZ appears to contribute to the development of QT prolongation, in particular with low concentrations of serum potassium or magnesium. Although mechanisms of Tdp development in patients with QT prolongation remain to be determined, it is possible that FCZ administration leads to manifestation of Tdp. Special cautions should be exercised upon the emergence of QT prolongation following FCZ administration.
长QT综合征常导致尖端扭转型室速（Tdp），这是一种潜在致命的心律失常。一名55岁患有M4Eo且正在接受巩固化疗的女性，在使用氟康唑（FCZ）后出现了长QT和Tdp发作。静脉补充硫酸镁以及多次尝试进行心脏电复律后心律失常得以恢复。FCZ似乎促成了QT延长的发生，尤其是在血清钾或镁浓度较低的情况下。虽然QT延长患者发生Tdp的机制仍有待确定，但使用FCZ有可能导致Tdp的出现。在使用FCZ后出现QT延长时应格外谨慎。
