Arsenic trioxide may be given as a chemotherapeutic agent for acute promyelocytic leukemia as well as other malignancies. Cardiac toxicity may limit its use.


Arsenic trioxide = (As)2(O)3


Physiologic effects of arsenic trioxide:

(1) prolongation of the QTc interval

(2) prolongation of the action potential


Arrhythmias that may occur:

(1) torsades de pointes

(2) non-sustained ventricular tachycardia

(3) ventricular premature contractions

(4) nonsustained supraventricular tachycardia

(5) sinus tachycardia


Risk factors for arrhythmias:

(1) high dose of the arsenic trioxide

(2) concurrent therapy with other drugs prolonging the QTc interval

(3) conditions associated with delayed cardiac repolarization (bradycardia, hypomagnesemia, hypokalemia)


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