Cardiac Morphology During Drug-Induced QT Prolongation: An Educational Review Using Ibogaine as an Illustrative Exposure

Drug-induced QT prolongation requires interpretation of interval duration, rhythm, repolarization morphology, serial change, and clinical status. This narrative educational review organizes acquired long QT guidance into a teaching sequence for ECG-trained clinicians, using ibogaine as an illustrative exposure. Clinical instability and ongoing malignant rhythms take priority over measurement exercises or recording descriptors. Classroom tasks practice evaluating measurement reliability, describing a defined interval, comparing it with baseline and prior events, and identifying findings that require escalation. W orked examples address endpoint selection, heart rate correction, rate history, and documented ventricular tachycardia. Human ibogaine and noribogaine studies are compared by population, ECG ascertainment, exposure, and concurrent interventions. Magnesium can suppress torsades recurrence without reliably shortening QT; preventive benefit during ibogaine exposure remains unestablished in controlled studies. Sustained polymorphic ventricular tachycardia requires immediate electrical treatment under applicable resuscitation guidance. The teaching sequence preserves numerical action thresholds and audience scope. Educational effectiveness remains unevaluated.