Hypokalaemia, Drugs and the QT interval – A Recipe for Disaster

Abstract

We enjoyed the recent article by Heaps and Gormley.1 It highlights both the importance of electrolyte disturbance and the QT interval, in the context of acute drug overdose or substance misuse. We recently managed a 40 year old gentleman who was admitted to our intensive care unit after resuscitation from an outof- hospital ventricular fibrillation (VF) cardiac arrest. He had a long history of smoking heroin, and occasional cannabis use. There was no other relevant past medical history and he had not reported any preceding illness. He was on an established methadone drug rehabilitation programme, taking 120mls/day, but took no other regular medications. There was no known family history of sudden cardiac death.