Reactions Weekly

, Volume 1733, Issue 1, pp 147–147 | Cite as


Torsades de pointes and polymorphic ventricular tachycardia (VT): 3 case reports
Case report
Author Information

An event is serious (based on the ICH definition) when the patient outcome is:

  • * death

  • * life-threatening

  • * hospitalisation

  • * disability

  • * congenital anomaly

  • * other medically important event

In a retrospective review of 265 patients admitted to Dartmouth-Hitchcock Medical Center between 2011 to 2016, three women aged 64−85 years were described who developed torsades de pointes (1 patient) and polymorphic VT (2 patients) following treatment with dofetilide [routes; not all durations of treatments to reactions onsets and outcomes stated].

Patient 1: The 85-year-old woman had cardiomyopathy, left ventricular ejection fraction of 34% and pulmonary hypertension. Three hours after the second dose of dofetilide 500µg, she developed 15 seconds of torsades de pointes. It was associated with a QTc that changed from 510 to 535 milliseconds.

Patient 2: The 75-year-old woman had non-obstructive coronary disease, a left ventricular ejection fraction of 30%. She developed polymorphic VT after the fourth dose of dofetilide 500µg. It was associated with a QTc that changed from 434 milliseconds at baseline to 454 milliseconds.

Patient 3: The 64-year-old woman had atrial fibrillation ablation and presumed tachymyopathy. She developed polymorphic VT that converted to monomorphic VT before spontaneously terminating. It was associated with a QTc change from 479 milliseconds at baseline to 541 milliseconds after receiving the third dose of dofetilide 500µg.

Author comment: "There were 3 patients (1.1%) with dofetilide discontinuation secondary to torsades de pointes or polymorphic VT."


  1. Wang SY, et al. Dofetilide-associated QT prolongation: Total body weight versus adjusted or ideal body weight for dosing. Journal of Cardiovascular Pharmacology 72: 161-165, No. 3, 01 Sep 2018. Available from: URL: - USACrossRefPubMedGoogle Scholar

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