Long QTc during methadone maintenance contributors and interventions over 4 years

Joseph J Westermeyer, Paul Thuras, Gihyun Yoon, Tegan Batres-Y-Carr

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Our goal consisted of describing the 4-year prevalence, contributors, and interventions for long QTc's in methadone maintenance treatment. Cardiologists' diagnosis of long QTc defined case-ness in 62 patients. Long QTc categories, drawn from epidemiological reports, encompassed 440 to 469 (borderline), 470 to 499 (moderate), and 500+ milliseconds (severe). Data collection included electrocardiograms, demographic characteristics, contributors to long QTc, and interventions-plus-outcomes (defined by resolution of long QTc). Of 62 patients, 21 had 39 long QTc episodes'a 4-year case prevalence of 34%, and an annual episode incidence of 15.7 per 100. Contributing factors identified in 36 of 39 episodes consisted of medication management (n = 19), illicit drug use (n = 11), and other factors (n = 6). Long QTc reverted to normal in 38 of 39 episodes. Of 21 patients, 12 (57%) experienced one or two recurrences. Methadone maintenance treatment physicians normalized most episodes as outpatients, often in collaboration with patients' primary care physicians. One fifth of episodes required hospitalization and other specialty care. Lack of timely QTc normalization may have accounted for one sudden death.

Original languageEnglish (US)
Pages (from-to)925-930
Number of pages6
JournalJournal of Nervous and Mental Disease
Volume205
Issue number12
DOIs
StatePublished - 2017

Bibliographical note

Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • Etiology
  • Long QTc
  • Maintenance treatment
  • Methadone
  • Prevalence of long QTc
  • Recurrence of long QTc
  • Treatment outcome for long QTc

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