Drug-Induced Prolongation of the QT Interval

To the Editor: Roden (March 4 issue)¹ provides a concise review of drug-induced prolongation of the QT interval. However, in Table 2 of the article, which lists risk factors for torsade de pointes, diet and fasting are not mentioned. There have been several reports of prolongation of the QT interval and associated torsade de pointes resulting from protein-sparing diets, starvation, anorexia nervosa, and fasting during a hunger strike.²⁵ Consequently, physicians should pay particular attention whenever prescribing QT-interval–prolonging drugs in patients in such circumstances. To the Editor: New data could be added to Roden's review. First, only 19 percent of . . .