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The author concludes that when physicians need to use a medication known to have the effect of prolonging the QT interval, a review of other risk factors that may increase the likelihood that torsades de pointes will develop is recommended. Therefore, an elderly woman with heart failure who also takes medications that might indirectly lead to increased risk (., diuretic use causing hypokalemia) would be a particularly risky candidate for use of a drug that prolongs the QT interval. Close clinical and electrocardiographic monitoring would be prudent during treatment.