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J Interv Card Electrophysiol. 2008 Nov;23(2):117-9. doi: 10.1007/s10840-008-9280-8. Epub 2008 Aug 7.

Successful transition to buprenorphine in a patient with methadone-induced torsades de pointes.

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  • 1Department of Cardiology, Beth Israel Medical Center, 1st Ave. at 16th Street, Baird Hall, 5th Floor, New York, NY, 10003, USA.


A 56-year-old-man presented with syncope and torsades de pointes secondary to methadone-induced QT prolongation. After transition from methadone to buprenorphine, a partial mu-opiate-receptor agonist and a kappa-opiate-receptor antagonist, the QT normalized and ventricular arrhythmias resolved. Buprenorphine should be used for opiate dependence and chronic pain in patients with methadone-induced QT prolongation and as first line therapy in patients with risk factors for torsades de pointes.

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