QT interval prolongation is a known risk factor for development of malignant ventricular arrhythmias. Measurement of the QT interval is difficult in the setting of ventricular pacing (VP), which can prolong depolarization and increase the QT interval, overestimating repolarization time. VP and cardiac resynchronization therapies have become commonplace in modern cardiac care and may contribute to repolarization heterogeneity and subsequent increased risk for ventricular arrhythmias including Torsades de Pointes. It is imperative for the clinician caring for acutely ill cardiac patients to understand the relationship between QT interval prolongation, both drug-induced and pacing-induced, and repolarization changes with subsequent ventricular arrhythmia risk. In this review, we discuss the components of QT interval assessment for arrhythmogenic risk including arrhythmogenic QT prolongation, methods for adjusting the QT interval to identify repolarization changes, methods to adjust for heart rate, and propose a framework for medication management to assess for drug-induced long QT syndrome in patients with VP.

QT 间期延长是发生恶性室性心律失常的已知危险因素。在心室起搏 (VP) 的情况下很难测量 QT 间期，这会延长除极和增加 QT 间期，高估复极时间。VP 和心脏再同步化疗法在现代心脏护理中已变得司空见惯，并可能导致复极异质性和随后增加的室性心律失常风险，包括尖端扭转型室性心动过速。护理急性心脏病患者的临床医生必须了解 QT 间期延长（包括药物引起的和起搏引起的）和复极变化与随后的室性心律失常风险之间的关系。在本次审查中，