SHM Converge Scientific Abstract ePoster Gallery-Breaking the Cycle: Life Saving Implantable Cardioverter Defibrillator in Methadone-Induced Torsades De Pointes

Breaking the Cycle: Life Saving Implantable Cardioverter Defibrillator in Methadone-Induced Torsades De Pointes

Pdf Summary

This document highlights the cardiac risks and treatment considerations in patients with opioid use disorder (OUD) who are receiving methadone. Methadone is described as a highly effective, life-saving therapy that can reduce mortality and overdoses by up to 50%, but it is also associated with QT prolongation and, in rare cases, torsades de pointes (TdP), which can lead to cardiac arrest.<br /><br />The learning objectives focus on three main areas: understanding the incidence and risk factors for methadone-related QT prolongation, using shared decision-making when evaluating OUD treatment options after a TdP-related cardiac arrest, and recognizing when a secondary prevention implantable cardioverter-defibrillator (ICD) may be appropriate for patients who wish to remain on methadone.<br /><br />The conclusion emphasizes that, for some patients, methadone remains the preferred and most effective treatment despite prior serious arrhythmic events. In patients who have survived TdP-associated cardiac arrest, have already failed buprenorphine therapy, and strongly prefer to continue methadone, a secondary prevention ICD should be carefully considered and advocated for as a life-saving measure. The overall message is that treatment decisions should balance the proven benefits of methadone for OUD against its potential cardiac dangers, with patient preferences and shared decision-making playing a central role.

Asset Subtitle

Tara K. Ward

Meta Tag

Author List Catherine Callister, Elizabeth McWilliams, Haley Briggs, PA-C, Tara K. Ward

Category Clinical Vignettes

Concept Methadone

Concept Opioid Use Disorder

Concept Antipsychotic-Induced QT Prolongation

Concept Torsades de Pointes

Concept Cardiac Arrest

Distinguished Non-Finalist

Presenter Organization University of Colorado Hospital

Presenting Author Tara K. Ward

Track Adult

Keywords

methadone

opioid use disorder

QT prolongation

torsades de pointes

cardiac arrest

shared decision-making

buprenorphine

implantable cardioverter-defibrillator

secondary prevention ICD

arrhythmia risk

Methadone

Opioid Use Disorder

Antipsychotic-Induced QT Prolongation

Torsades de Pointes

Cardiac Arrest