CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 5, June 2013
AFRICA
e11
Case Report
Ventricular tachycardia-based long QT without
hypocalcaemia after use of ibandronic acid
YUSUF IZZETTIN ALIHANOGLU, BURCU ULUDAG, ISMAIL DOGU KILIC, UFUK ERYILMAZ, HARUN EVRENGUL
Abstract
Many drugs are known to cause lengthening of the QT inter-
val. Ibandronic acid is a frequently used agent in the treat-
ment of osteoporosis and is known to cause prolongation of
the QT interval due to hypocalcaemia. However, no cases of
long QT syndrome associated with ventricular tachycardia
(VT) with a serum calcium level within the normal limits
have been reported in the literature. We report on a case of
a VT-based long QT syndrome associated with the use of
ibandronic acid.
Keywords:
long QT, ventricular tachycardia, ibandronic acid,
cardioversion
Submitted 28/1/13, accepted 10/5/13
Cardiovasc J Afr
2013;
24
: e11–e14
DOI: 10.5830/CVJA-2013-037
Long QT syndrome is important because it triggers life-
threatening arrhythmias and poses the risk of sudden cardiac
death. Long QT syndrome can be divided into two forms:
congenital and acquired.
1
Anti-arrhythmic agents, non-sedative
antihistamines, antipsychotic agents, and gastrointestinal
prokinetic agents are the most widely encountered causes of
acquired long QT syndrome.
2
Bisphosphonate agents are widely used in the treatment of
osteoporosis.
3
Ibandronic acid is a bisphosphonate agent with
no significant reported cardiovascular side effects. This report
presents a case of acquired long QT syndrome that degenerated
into malignant arrhythmia associated with the use of ibandronic
acid.
Case report
A 57-year-old female patient with palpitations came to the
external centre in a serious condition. She was transferred to
our centre after starting medical cardioversion with intravenous
Department of Cardiology, Medical Faculty, Pamukkale
University, Denizli, Turkey
YUSUF IZZETTIN ALIHANOGLU, MD,
BURCU ULUDAG, MD
ISMAIL DOGU KILIC, MD
HARUN EVRENGUL, MD
Department of Cardiology, Medical Faculty, Adnan
Menderes University, Aydin, Turkey
UFUK ERYILMAZ, MD
Fig. 1. Monomorphic ventricular tachycardia and captured sinus beat seen on the surface 12-lead ECG, taken at the
first admission.
