J Dent Anesth Pain Med.  2017 Dec;17(4):323-327. 10.17245/jdapm.2017.17.4.323.

QT-interval prolongation due to medication found in the preoperative evaluation

• Seto M
• Koga S
• Kita R
• Kikuta T

• KMID: 2399804
• DOI: http://doi.org/10.17245/jdapm.2017.17.4.323

Abstract

QT prolongation is an electrocardiographic change that can lead to lethal arrhythmia. Acquired QT prolongation is known to be caused by drugs and electrolyte abnormalities. We report three cases in which the prolonged QT interval was improved at the time of operation by briefly discontinuing the drugs suspected to have caused the QT prolongation observed on preoperative electrocardiography. The QTc of cases 1, 2, and 3 improved from 518 to 429 ms, 463 to 441 ms, and 473 to 443 ms on discontinuing the use of a gastrointestinal prokinetic agent, a proton pump inhibitor, and a molecular targeted drug, respectively. These cases were considered to have drug-induced QT prolongation. We reaffirmed that even drugs administered for conditions unrelated to cardiac diseases can have adverse side effect of QT prolongation. In conclusion, our cases indicate that dental surgeons should be aware of the dangerous and even potentially lethal side effects of QT prolongation. For safe oral and maxillofacial surgery, cooperation with medical departments in various fields is important.

Keyword

Drug-induced QT Prolongation; Lethal Arrhythmia; Pre-operative evaluation

MeSH Terms

Arrhythmias, Cardiac
Electrocardiography
Heart Diseases
Proton Pumps
Surgeons
Surgery, Oral
Proton Pumps

Figure

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  Fig. 1 Electrocardiogram of case 1 (a) at first visit and (b) on day 6 after cessation of mosapride citrate hydrate.

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  Fig. 2 Electrocardiogram of case 2 (a) at first visit and (b) on day 3 after cessation of lansoprazole.

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  Fig. 3 Electrocardiogram of case 3 (a) at first visit and (b) on day 3 after cessation of dasatinib.

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