Tricyclic medication in children and the QT interval: case report and discussion.

OBJECTIVE

To identify the necessity for close monitoring of the QT interval in children and adolescents treated with tricyclics.

METHOD

Guidelines for permissible ECG changes are reviewed and a case report of a 12-year-old girl with idiopathic long QT syndrome, no history of cardiac disorder, a questionable family history, and normal physical examination and baseline ECG is presented.

RESULTS

Marked increase in QT corrected for heart rate (QTc) occurred on low-dose tricyclic. Possible factors in deaths on desipramine are reviewed.

CONCLUSION

It is recommended that children and adolescents on tricyclics receive an ECG at baseline and after each dose increase. Recommendations are made regarding ECG parameters and indications for cardiac consultation.