Long QT Syndrome and Perioperative Torsades de Points: What the Anesthesiologist Should Know

Abstract Perioperative Torsade de Pointes (TdP) is a potentially fatal arrhythmia. The association between the prolongation of corrected QT (QTc) interval and TdP has been well described, but prolonged QTc interval is likely not to be a sole determinant. The transmural dispersion of repolarization (TDR) represents regional heterogeneities in repolarization. Prolonged TDR is also considered responsible for TdP. Here we reviewed the current knowledge of perioperative TdP and their known mechanism along with risk factors including drugs. A number of perioperative drugs were reviewed for their effect on QT prolongation and TDR.