QT Prolongation: Risk Factors and Considerations

QT Prolongation: Risk Factors and Considerations - #100

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Review medical conditions and medications that can prolong QT

This GFF reviews individual risk factors for prolonged QT and common medications that can prolong the QT.

Decide the safest pharmacologic options in relation to the risk of QT prolongation. For individuals with a prolonged QT, consider lower risk treatment options when possible. Better recognize medications that pose a higher risk.

Recognize and mitigate risk factors for QT prolongation

Beach, S. R., Celano, C. M., Sugrue, A. M., Adams, C., Ackerman, M. J., Noseworthy, P. A., & Huffman, J. C. (2018). QT prolongation, torsades de pointes, and psychotropic medications: a 5-year update. Psychosomatics59(2), 105-122.

Desai, N., Venkatesh, C. R., & Kumar, S. S. (2015). QT prolongation and torsades de pointes with psychotropic agents. Indian journal of psychiatry57(3), 305–308. https://doi.org/10.4103/0019-5545.166619

Funk, K. A., & Bostwick, J. R. (2013). A comparison of the risk of QT prolongation among SSRIs. Annals of Pharmacotherapy47(10), 1330-1341.

Gupta, A., Lawrence, A. T., Krishnan, K., Kavinsky, C. J., & Trohman, R. G. (2007). Current concepts in the mechanisms and management of drug-induced QT prolongation and torsade de pointes. American heart journal153(6), 891-899.

Isbister, G. K., & Page, C. B. (2013). Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice. British journal of clinical pharmacology76(1), 48-57.

Jankelson, L., Karam, G., Becker, M. L., Chinitz, L. A., & Tsai, M. C. (2020). QT prolongation, torsades de pointes, and sudden death with short courses of chloroquine or hydroxychloroquine as used in COVID-19: A systematic review. Heart rhythm17(9), 1472-1479.

Li, M., & Ramos, L. G. (2017). Drug-induced QT prolongation and torsades de pointes. Pharmacy and Therapeutics42(7), 473.

Liperoti, R., Gambassi, G., Lapane, K. L., Chiang, C., Pedone, C., Mor, V., & Bernabei, R. (2005). Conventional and atypical antipsychotics and the risk of hospitalization for ventricular arrhythmias or cardiac arrest. Archives of Internal Medicine165(6), 696-701.

Owens, R. C. (2004). QT prolongation with antimicrobial agents. Drugs64(10), 1091-1124.

Stöllberger, C., Huber, J. O., & Finsterer, J. (2005). Antipsychotic drugs and QT prolongation. International clinical psychopharmacology20(5), 243-251.

Swenson, R. S., & Murphy-Ende, K. (2020). Prolonged QT interval in patients receiving psychotropic medications. Journal of the American Psychiatric Nurses Association26(4), 344-353.

Vandenberk, B., Vandael, E., Robyns, T., Vandenberghe, J., Garweg, C., Foulon, V., ... & Willems, R. (2016). Which QT correction formulae to use for QT monitoring?. Journal of the American Heart Association5(6), e003264.

Wu, C. S., Tsai, Y. T., & Tsai, H. J. (2015). Antipsychotic drugs and the risk of ventricular arrhythmia and/or sudden cardiac death: a nation‐wide case‐crossover study. Journal of the American Heart Association4(2), e001568.

Yap, Y. G., & Camm, A. J. (2003). Drug induced QT prolongation and torsades de pointes. Heart89(11), 1363-1372.


Examples of lists online of QT Prolonging Medications:



This GFF ___ my competence in geriatrics.

Hannah Reiland DO, Medical College of Wisconsin

Katherine Levine MD Medical College of Wisconsin