This secondary analysis of a randomized clinical trial involving 566 ICU patients with delirium and baseline QTc intervals less than 550 ms investigated the effects of antipsychotics on QTc intervals and the risk of fatal arrhythmias. The study found that neither haloperidol nor ziprasidone significantly increased the QTc intervals compared to placebo. Furthermore, there were no fatal cardiac arrhythmias related to the study drugs. These findings suggest that in ICU patients with delirium and a QTc interval under 550 ms, the use of these antipsychotics may not lead to clinically significant cardiac arrhythmias.
The findings of this trial suggest that daily QTc interval monitoring during antipsychotic use may have limited value in patients in the ICU with normal baseline QTc and few risk factors for QTc prolongation.
