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QT Prolongation and Life Threatening Ventricular Tachycardia in a Patient Injected With Intravenous Meperidine $(Demerol^{(R)})$

  • Song, Mi-Kyoung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Bae, Eun-Jung (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Baek, Jae-Suk (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kwon, Bo-Sang (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kim, Gi-Beom (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Noh, Chung-Il (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Choi, Jung-Yun (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Park, Sung-Sup (Department of Laboratory Medicine, Seoul National University College of Medicine)
  • 발행 : 2011.06.30

초록

QT prolongation is a serious adverse drug effect, which is associated with an increased risk of Torsade de pointes and sudden death. Many drugs, including both cardiac and non-cardiac drugs, have been reported to cause prolongation of QT interval. Although meperidine has not been considered proarrhythmic, we present a unique case of a 16-year-old boy without an underlying cardiac disease, who developed polymorphic ventricular tachycardia, ventricular fibrillation and QT prolongation after an intravenous meperidine injection. He had no mutation in long QT syndrome genes (KCNQ1, KCNH2, and SCN5A), but single nucleotide polymorphisms were reported, including H558R in SCNA5A and K897T in KCNH2.

키워드

참고문헌

  1. Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med 2004;350:1013-22. https://doi.org/10.1056/NEJMra032426
  2. Wedam EF, Bigelow GE, Johnson RE, Nuzzo PA, Haigney MC. QT-interval effects of methadone, levomethadyl, and buprenorphine in a randomized trial. Arch Intern Med 2007;167:2469-75. https://doi.org/10.1001/archinte.167.22.2469
  3. Shimizu W, Noda T, Takaki H, et al. Diagnostic value of epinephrine test for genotyping LQT1, LQT2, and LQT3 forms of congenital long QT syndrome. Heart Rhythm 2004;1:276-83. https://doi.org/10.1016/j.hrthm.2004.04.021
  4. Kim SM, Kim DS, Kim DI, et al. Quinidine-induced QTc interval prolongation and gender differences in healthy Korean subjects. Korean Circ J 2007;37:559-66. https://doi.org/10.4070/kcj.2007.37.11.559
  5. Velebit V, Podrid P, Lown B, Cohen BH, Graboys TB. Aggravation and provocation of ventricular arrhythmias by antiarrhythmic drugs. Circulation 1982;65:886-94. https://doi.org/10.1161/01.CIR.65.5.886
  6. De Ponti F, Poluzzi E, Montanaro N, Ferguson J. QTc and psychotropic drugs. Lancet 2000;356:75-6.
  7. Hoffmann P, Warner B. Are hERG channel inhibition and QT interval prolongation all there is in drug-induced torsadogenesis? A review of emerging trends. J Pharmacol Toxicol Methods 2006;53:87-105. https://doi.org/10.1016/j.vascn.2005.07.003
  8. Katchman AN, McGroary KA, Kilborn MJ, et al. Influence of opioid agonists on cardiac human ether-a-go-go-related gene K(+) currents. J Pharmacol Exp Ther 2002;303:688-94. https://doi.org/10.1124/jpet.102.038240
  9. Donger C, Denjoy I, Berthet M, et al. KVLQT1 C-terminal missense mutation causes a forme fruste long-QT syndrome. Circulation 1997; 96:2778-81. https://doi.org/10.1161/01.CIR.96.9.2778
  10. Napolitano C, Schwartz PJ, Brown AM, et al. Evidence for a cardiac ion channel mutation underlying drug-induced QT prolongation and life-threatening arrhythmias. J Cardiovasc Electrophysiol 2000;11: 691-6. https://doi.org/10.1111/j.1540-8167.2000.tb00033.x
  11. Paulussen AD, Gilissen RA, Armstrong M, et al. Genetic variations of KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2 in drug-induced long QT syndrome patients. J Mol Med 2004;82:182-8. https://doi.org/10.1007/s00109-003-0522-z
  12. Sesti F, Abbott GW, Wei J, et al. A common polymorphism associated with antibiotic-induced cardiac arrhythmia. Proc Natl Acad Sci U S A 2000;97:10613-8. https://doi.org/10.1073/pnas.180223197
  13. Hyun DW, Han SW, Jo YK, et al. Moleculogenetic characteristics of the patient with long QT syndrome in Korean. Korean Circ J 2004;34: 813-9.
  14. Yang P, Kanki H, Drolet B, et al. Allelic variants in long-QT disease genes in patients with drug-associated torsades de pointes. Circulation 2002;105:1943-8. https://doi.org/10.1161/01.CIR.0000014448.19052.4C
  15. Albert CM, MacRae CA, Chasman DI, et al. Common variants in car-diac ion channel genes are associated with sudden cardiac death. Circ Arrhythm Electrophysiol 2010;3:222-9. https://doi.org/10.1161/CIRCEP.110.944934
  16. Gouas L, Nicaud V, Berthet M, et al. Association of KCNQ1, KCNE1, KCNH2 and SCN5A polymorphisms with QTc interval length in a healthy population. Eur J Hum Genet 2005;13:1213-22. https://doi.org/10.1038/sj.ejhg.5201489
  17. Gouas L, Nicaud V, Chaouch S, et al. Confirmation of associations be-tween ion channel gene SNPs and QTc interval duration in healthy subjects. Eur J Hum Genet 2007;15:974-9. https://doi.org/10.1038/sj.ejhg.5201866
  18. Pietila E, Fodstad H, Niskasaari E, et al. Association between HERG K897T polymorphism and QT interval in middle-aged Finnish women. J Am Coll Cardiol 2002;40:511-4. https://doi.org/10.1016/S0735-1097(02)01979-4
  19. Bezzina CR, Verkerk AO, Busjahn A, et al. A common polymorphism in KCNH2 (HERG) hastens cardiac repolarization. Cardiovasc Res 2003;59:27-36. https://doi.org/10.1016/S0008-6363(03)00342-0
  20. Crotti L, Lundquist AL, Insolia R, et al. KCNH2-K897T is a genetic mo-difier of latent congenital long-QT syndrome. Circulation 2005;112: 1251-8. https://doi.org/10.1161/CIRCULATIONAHA.105.549071

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