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William A. Baker, MD; Mori J. Krantz, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We commend Wedam et al¹ for their addition to the medical literature regarding the prolongation of the rate-corrected QT (QTc) interval associated with opioid pharmacotherapy. Although the effect of methadone on cardiac repolarization has been documented in a prospective cohort study,² the study by Wedam et al¹ is the first randomized trial to our knowledge that compares the impact of levomethadyl acetate, methadone hydrochloride, and buprenorphine hydrochloride on the QTc interval. It is now clear that substantial QTc interval prolongation with methadone may be fairly common, since the authors observed that 23% of methadone-treated subjects with a normal QTc interval at baseline developed QTc prolongation during treatment. The comparatively lower risk of QTc prolongation with buprenorphine is consistent with its lower potency in blocking the cardiac delayed rectifier potassium ion channel.

We wish to point out an important limitation in the analysis . . . [Full Text of this Article]

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QT-Interval Effects of Methadone, Levomethadyl, and Buprenorphine in a Randomized Trial
Erich F. Wedam, George E. Bigelow, Rolley E. Johnson, Paul A. Nuzzo, and Mark C. P. Haigney
Arch Intern Med. 2007;167(22):2469-2475.
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