Drug-Induced QT Prolongation in Women During the Menstrual Cycle

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Abstract
Women have slower cardiac repolarization than men, which manifests as longer heart rate corrected QT intervals (QTc) on the electrocardiogram (ECG).1 This sex difference is apparent only after puberty.2 Furthermore, women are more prone than men to develop torsades de pointes ventricular arrhythmias after administration of drugs that prolong cardiac repolarization (eg, antiarrhythmic drugs, terfenadine, erythromycin, etc).3-5 These findings suggest a role for sex hormones in the response to drugs that alter cardiac repolarization, and animal studies have demonstrated that sex hormones can alter potassium channel expression, ion currents, cardiac repolarization, and QT response to drugs.6-9