Clinical Characterization of Men with Long QT Syndrome and Torsades de Pointes Associated with Hypogonadism: A Review and Pharmacovigilance Study

The study investigated the clinical characteristics of men with acquired Long QT Syndrome (LQTS) and Torsades de Pointes (TdP) associated with hypogonadism, either due to endocrine conditions or androgen deprivation therapy (ADT). Seven cases of TdP with hypogonadism were identified, with one resulting in fatality. Correcting low testosterone levels in the six surviving patients led to normalization of QTc intervals and T-wave morphology, with no recurrence of TdP. Additionally, 27 reports of men with LQTS, TdP, or sudden death suspected to be induced by ADT were analyzed, with the majority being prostate cancer patients. Withdrawal of ADT generally resulted in shortened QTc and no TdP recurrence. The study concluded that hypogonadism is a risk factor for TdP in men and that testosterone treatment may be beneficial in treating or preventing TdP.