Abstract
In acquired human immunodeficiency virus (HIV) infection, a long depolarization period at ECG may be the consequence of cardiac complications due to viral myocarditis or cardiomyopathy or indirectly due to autonomic neuropathy, or sometimes resulting from pharmacological treatments. Several drugs administered for direct treatment of HIV disease or its complications, such as anti-retrovirus, fluconazole, and antibiotics, may induce ventricular arrhythmias due to long QT prolonged depolarization period. Also methadone, frequently associated with HIV therapy to treat patients with opiate addiction, is described in the literature to have cardiac inotropic effects. It has also the potential to increase the QT period and to develop ventricular torsade de pointes, primarily through interference with the rapid component of the delayed rectifier potassium ion current. Moreover, the use of methadone associated with other inhibitors of cytochrome P450 might increase plasma concentrations and contribute to methadone cardiac toxicity. We report the case of an HIV patient receiving antiretroviral treatment, flucanazole and high-dose methadone, who suddenly complained of vertigo, dizziness, pre-syncope and syncope due to severe ventricular arrhythmias that disappeared after discontinuation of all treatments.
| Original language | Italian |
|---|---|
| Pages (from-to) | 735-740 |
| Number of pages | 6 |
| Journal | Italian Heart Journal Supplement |
| Volume | 5 |
| Issue number | 9 |
| Publication status | Published - 2004 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Allungamento del QT e torsione di punta in un paziente con immunodeficienza virale acquisita in multiterapia con farmaci utilizzatori del citocromo P450. / Hrovatin, Enzo; Zardo, Fabio; Brieda, Marco; Dametto, Ermanno; Piazza, Rita; Antonini-Canterin, Francesco; Cassin, Matteo; Meneguzzo, Nereo; Viel, Elda; Lestuzzi, Chiara; Di Gennaro, Gianpiero; Nicolosi, Gian Luigi.
In: Italian Heart Journal Supplement, Vol. 5, No. 9, 2004, p. 735-740.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Allungamento del QT e torsione di punta in un paziente con immunodeficienza virale acquisita in multiterapia con farmaci utilizzatori del citocromo P450
AU - Hrovatin, Enzo
AU - Zardo, Fabio
AU - Brieda, Marco
AU - Dametto, Ermanno
AU - Piazza, Rita
AU - Antonini-Canterin, Francesco
AU - Cassin, Matteo
AU - Meneguzzo, Nereo
AU - Viel, Elda
AU - Lestuzzi, Chiara
AU - Di Gennaro, Gianpiero
AU - Nicolosi, Gian Luigi
PY - 2004
Y1 - 2004
N2 - In acquired human immunodeficiency virus (HIV) infection, a long depolarization period at ECG may be the consequence of cardiac complications due to viral myocarditis or cardiomyopathy or indirectly due to autonomic neuropathy, or sometimes resulting from pharmacological treatments. Several drugs administered for direct treatment of HIV disease or its complications, such as anti-retrovirus, fluconazole, and antibiotics, may induce ventricular arrhythmias due to long QT prolonged depolarization period. Also methadone, frequently associated with HIV therapy to treat patients with opiate addiction, is described in the literature to have cardiac inotropic effects. It has also the potential to increase the QT period and to develop ventricular torsade de pointes, primarily through interference with the rapid component of the delayed rectifier potassium ion current. Moreover, the use of methadone associated with other inhibitors of cytochrome P450 might increase plasma concentrations and contribute to methadone cardiac toxicity. We report the case of an HIV patient receiving antiretroviral treatment, flucanazole and high-dose methadone, who suddenly complained of vertigo, dizziness, pre-syncope and syncope due to severe ventricular arrhythmias that disappeared after discontinuation of all treatments.
AB - In acquired human immunodeficiency virus (HIV) infection, a long depolarization period at ECG may be the consequence of cardiac complications due to viral myocarditis or cardiomyopathy or indirectly due to autonomic neuropathy, or sometimes resulting from pharmacological treatments. Several drugs administered for direct treatment of HIV disease or its complications, such as anti-retrovirus, fluconazole, and antibiotics, may induce ventricular arrhythmias due to long QT prolonged depolarization period. Also methadone, frequently associated with HIV therapy to treat patients with opiate addiction, is described in the literature to have cardiac inotropic effects. It has also the potential to increase the QT period and to develop ventricular torsade de pointes, primarily through interference with the rapid component of the delayed rectifier potassium ion current. Moreover, the use of methadone associated with other inhibitors of cytochrome P450 might increase plasma concentrations and contribute to methadone cardiac toxicity. We report the case of an HIV patient receiving antiretroviral treatment, flucanazole and high-dose methadone, who suddenly complained of vertigo, dizziness, pre-syncope and syncope due to severe ventricular arrhythmias that disappeared after discontinuation of all treatments.
KW - Cytochrome P450: HIV
KW - Torsade de pointes
UR - http://www.scopus.com/inward/record.url?scp=16644393946&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=16644393946&partnerID=8YFLogxK
M3 - Articolo
VL - 5
SP - 735
EP - 740
JO - Italian Heart Journal Supplement
JF - Italian Heart Journal Supplement
SN - 1129-4728
IS - 9
ER -