Key result
Hemodialysis triggered torsade de pointes in a 76-year-old man with a prolonged QT interval due to concurrent hypocalcemia and ciprofloxacin use.
Case Report (n=1)
Hemodialysis can trigger torsade de pointes in patients with underlying risk factors for QT prolongation such as hypocalcemia and ciprofloxacin use.
May warrant QT monitoring during hemodialysis with multiple risk factors; case report leaves open causality.
Torsade de pointes is a polymorphic form of ventricular tachycardia associated with prolongation of the QT interval, which may be either congenital or acquired. Etiologies for the acquired forms include drug effects, hypokalemia, hypomagnesemia, hypocalcemia, starvation, sick sinus syndrome, and atrioventricular block. We present a 76-year-old man with acute on chronic renal failure, hypocalcemia, on ciprofloxacin, and a prolonged QT interval with torsade de pointes triggered by hemodialysis. The QT prolongation was corrected by treating the hypocalcemia. Hypocalcemia and ciprofloxacin are known to independently cause prolonged QT interval and torsade de pointes; our case illustrates that dialysis can trigger torsade on a background of this risk factor combination.
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Daya et al. (2004) conducted a case report in Torsade de pointes and prolonged QT interval (n=1). Hemodialysis in the setting of ciprofloxacin and hypocalcemia was evaluated on Torsade de pointes. Hemodialysis triggered torsade de pointes in a 76-year-old man with a prolonged QT interval due to concurrent hypocalcemia and ciprofloxacin use.
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