QTc prolongation in acute medical admissions: an often overlooked and potentially serious finding

QTc prolongation creates an electrophysiological environment that confers an increased risk for development of ventricular arrhythmias, in particular torsades de pointes (TdP), a form of polymorphic ventricular tachycardia. This may result in syncope or sudden cardiac death.1–5 In addition, prolonged QTc at admission has been associated with worse outcomes independent of malignant ventricular rhythms.6 Figure 1 shows an example of an ECG with a prolonged QTc of 550 ms.

Numerous studies have demonstrated a high prevalence of QTc prolongation among patients admitted to the hospital in a wide variety of settings including the intensive care unit and acute psychiatric units.7 8

In our centre, we sought to determine the prevalence of QTc prolongation among patients admitted on medical take through our emergency department. We also analysed the presence or absence of drugs associated with QTc prolongation in these...

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