We present a case of Torsade de Pointes secondary to multiple factors including patient susceptibility and iatrogenic influences. Contributing causes are presented, and the approach to treatment is discussed

Bernard Topi

Chaim Gitelis

Gabriel Bombino

Gerald Hollander

Jinu John

Joydeep Ghosh

Xixi Amley

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Cardiology Research and Practice

Autonomic neuropathy and prolongation of QT interval in human immunodeﬁ-ciency virus infection,”

Electrocardiogram characteristics of methadone and buprenorphine maintained subjects,” J o u r n a lo fA d d i c t i v eD i s -eases,

for Education and Research on Therapeutics. University of Arizona College of Pharmacy. Resources for Professionals, “Torsades List: Drugs With a Risk of Torsades de

G.B.Ehret,C.Voide,M.Gex-Fabryetal.,“Drug-inducedlong QT syndrome in injection drug users receiving methadone: high frequency in hospitalized patients and risk factors,”

Giant T-U waves precede torsades de pointes in long QT syndrome: a systematic electrocardiographic analysis in patients with acquired and congenital QT prolongation,”

Impact of methadone treatment on cardiac repolarization and conduction in opioid users,”

Importance of hepatitis C coinfection in the development of QT prolongation in HIVinfected patients,”

Long QT(c) and torsades de pointes in human immunodeﬁciency virus disease,” Pacing and Clinical Electrophysiology,

Methadoneassociated QTc prolongation: a case report and review of the literature,”

o l d e n b e r g ,A .J .M o s s ,a n dW .Z a r e b a ,“ Q Ti n t e r v a l :h o w to measure it and what is “normal”,”

Okeahialam, “QTc interval prolongation in patients with HIV and

QTc interval screening in methadone treatment,”

Relationship between HIV protease inhibitors and QTc interval duration in HIVinfected patients: a cross-sectional study,”

S c h o u t e n ,J .M .D e k k e r ,P .M e p p e l i n k

Taking the “idio” out of “idiosyncratic”: predicting torsades de pointes,”

Torsade de Pointes due to Methadone Use in a Patient with HIV and Hepatitis C Coinfection