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start QRS to end T (duration of activation and recovery of ventricular myometrium) so if prolonged next depolarisation may be incomplete and contraction ineffective
If >0.44 secs associated with ventricular arrythmyias, syncope and sudden death
If >500 or torsade de point - refer

''causes''
drugs
hypo - K,Mg,Ca,thermia
congenital - AD and AR, FH sudden death (cardiac <40yrs)

Avoid drug if possible if underlying cardiac disease
Avoid drug if possible if on other drugs that prolong QT
If inc risk of arrhythmias monitor Ca, K, Mg

''Drugs''
Tricyclic - Amitryp
Anti-arrhythmic - amiod, sotalol
anti-histamine - terfenadine, astemizole
anti-malarial - halofantrine
anti-psychotics - droperidol, thioridazine
cisapride
methodone, cocaine
citalopram and escitalopram