[Atrial fibrillation and QT prolongation due to proton pump inhibitor-induced hypomagnesemia]

Ann Cardiol Angeiol (Paris). 2020 Oct;69(4):201-203. doi: 10.1016/j.ancard.2020.07.016. Epub 2020 Aug 12.
[Article in French]

Abstract

Proton pump inhibitors are widely prescribed but their long-term use can expose patients to adverse effects. Some of these are not very well known, including hypomagnesemia. Hypomagnesemia can be manifested by cardiac complications such as supraventricular arrhythmia or QT prolongation, increasing the risk of torsade de pointe. We present a case of atrial fibrillation triggered by severe hypomagnesemia secondary to proton pump inhibitor use and exacerbated by thiazide diuretic treatment. Conversion to sinus rhythm showed a prolonged corrected QT interval. We approach the pathophysiology and the electrophysiologic effects of hypomagnesemia.

Keywords: Allongement du QT; Atrial fibrillation; Diurétiques thiazidiques; Fibrillation atriale; Hypomagnesemia; Hypomagnésémie; Iatrogeny; Iatrogénie; Inhibiteurs de la pompe à protons; Proton pump inhibitors; QT prolongation; Thiazide diuretics.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / etiology*
  • Diuretics / adverse effects*
  • Drug Synergism
  • Electrocardiography
  • Humans
  • Hypocalcemia / diagnosis
  • Hypocalcemia / drug therapy
  • Long QT Syndrome / drug therapy
  • Long QT Syndrome / etiology*
  • Magnesium / metabolism
  • Magnesium Deficiency / chemically induced*
  • Magnesium Deficiency / complications*
  • Magnesium Deficiency / drug therapy
  • Male
  • Proton Pump Inhibitors / adverse effects*

Substances

  • Diuretics
  • Proton Pump Inhibitors
  • Magnesium