Atypical Ventricular Tachycardia after Arsenic Poisoning

To the Editor: It is possible, as Goldsmith and From suggest in the issue of November 6, that the ability of arsenic to cause serious ventricular arrhythmias has escaped notice over the past century of comprehensive study. An alternative explanation for the atypical ventricular tachycardia in their patient — treatment with quinidine-like drugs — is more plausible and is worth arguing. There is no question that arsenic can cause QT prolongation in animals¹ and human beings, ² but such prolongation has not previously been reported to progress to torsade de pointe. The most common cause for that arrhythmia, when it is.