Cardiac arrest due to torsade de pointes (TdP) in the acquired form of drug-induced long-QT syndrome (LQTS) is a rare but potentially catastrophic event in hospital settings.  The purpose of this scientific statement from the American Heart Association and the American College of Cardiology Foundation is to raise awareness among those who care for patients in hospital units about the risk, ECG monitoring, and management of drug-induced LQTS.  Topics reviewed include the following:

• ECG characteristics of TdP and signs of impending arrhythmia
• Cellular mechanisms of acquired LQTS and current thinking about genetic susceptibility
• Drugs and drug combinations most likely to cause TdP
• Risk factors and exacerbating conditions
• Methods to monitor QT intervals in hospital settings
• Immediate management of marked QT prolongation and TdP