Acquired short QT syndrome in a cancer patient treated with Toad

Abstract

Although drug‐induced short QT syndrome (SQTS) has been recognized, we currently report the first acquired SQTS case induced by bufotalinin (toad, an antineoplastic drug), which is a traditional Chinese folk prescription. It has cross reaction with digoxin and affects the Na+‐K+‐ATPase, the SR Ca2+ release from ryanodine receptor‐2 (RyR2), the reactive oxygen species (ROS) production from the mitochondria. The case presented with bradycardia, extreme QT shortening, and sinoatrial block that were resolved after gastric lavage, rehydration, electrolyte (hyperkalemia, hyponatremia, hypocalcemia) correction, and atropine injection. Clinicians should recognize a potential association between toad poisoning and SQTS from this case.

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“…Some hERG mutations can cause short QT syndrome and arrhythmias due to the increased I hERG (Brugada et al, 2004;Schimpf et al, 2005). The possibility of drug-induced QT shortening has also been previously recognized (Schimpf et al, 2012;Huang et al, 2019).…”

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