Atkinson D, Dunne A, Parker M
Critical Care Unit, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
Anaesthesia. 2007 Sep;62(9):952-5. doi: 10.1111/j.1365-2044.2007.05129.x.
Methadone is known to prolong the QT interval and precipitate torsades de pointes. A 54-year-old prescription methadone user with hypokalaemia was referred to Critical Care with acute confusion and respiratory distress. Alcohol withdrawal was the presumed precipitant. The real precipitant only became evident on analysis of a 24-h ECG (Holter monitor) attached to the patient at the time. The patient had suffered prolonged (10 min) ventricular arrhythmias including torsades de pointes and self-terminating ventricular fibrillation. The patient made a full recovery. Risk factors for acquired long QT syndrome and the treatment of torsades de pointes are discussed.
已知美沙酮会延长QT间期并引发尖端扭转型室性心动过速。一名54岁的美沙酮处方使用者伴有低钾血症，因急性意识模糊和呼吸窘迫被转诊至重症监护病房。推测诱因是酒精戒断。真正的诱因在分析患者当时佩戴的24小时心电图（动态心电图监测仪）时才变得明显。患者曾出现长时间（10分钟）的室性心律失常，包括尖端扭转型室性心动过速和自行终止的心室颤动。患者完全康复。文中讨论了获得性长QT综合征的危险因素以及尖端扭转型室性心动过速的治疗方法。
