Allungamento del QT e torsione di punta in un paziente con immunodeficienza virale acquisita in multiterapia con farmaci utilizzatori del citocromo P450

Translated title of the contribution: Prolonging QT interval and torsade de pointes in a patient with acquired human immunodeficiency virus in a multitherapy utilizing cytochrome P450

Enzo Hrovatin, Fabio Zardo, Marco Brieda, Ermanno Dametto, Rita Piazza, Francesco Antonini-Canterin, Matteo Cassin, Nereo Meneguzzo, Elda Viel, Chiara Lestuzzi, Gianpiero Di Gennaro, Gian Luigi Nicolosi

Research output: Contribution to journalArticle

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 languageItalian
Pages (from-to)735-740
Number of pages6
JournalItalian Heart Journal Supplement
Volume5
Issue number9
Publication statusPublished - 2004

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hrovatin, E., Zardo, F., Brieda, M., Dametto, E., Piazza, R., Antonini-Canterin, F., Cassin, M., Meneguzzo, N., Viel, E., Lestuzzi, C., Di Gennaro, G., & Nicolosi, G. L. (2004). Allungamento del QT e torsione di punta in un paziente con immunodeficienza virale acquisita in multiterapia con farmaci utilizzatori del citocromo P450. Italian Heart Journal Supplement, 5(9), 735-740.