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[CME ECG 66/Answers: Torsade de Pointes: The Danger of a Rotating Heart Axis]

Susanne Markendorf1, Ardan M Saguner1, Corinna Brunckhorst1

  • 1Universitätsspital Zürich, Klinik für Kardiologie.

Praxis
|October 14, 2020
PubMed

Insights

Torsade de pointes is a dangerous heart rhythm disorder caused by a prolonged QT interval. Early recognition and management are crucial to prevent life-threatening events like ventricular fibrillation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Education

Background:

  • Torsade de pointes (TdP) is a specific type of polymorphic ventricular tachycardia.
  • It is characterized by QT interval prolongation, which can be congenital or acquired.
  • Acquired TdP is frequently associated with pharmacologic agents.

Purpose of the Study:

  • To elucidate the etiology of Torsade de pointes.
  • To describe the diagnostic criteria for TdP.
  • To outline strategies for the prevention and management of TdP.

Main Methods:

  • Review of existing literature on Torsade de pointes.
  • Analysis of electrocardiographic (ECG) findings characteristic of TdP.
  • Discussion of clinical scenarios and therapeutic interventions.

Main Results:

  • Torsade de pointes is identified by a unique undulating QRS axis on the ECG.
  • QT interval prolongation is the primary electrophysiological abnormality.
  • While often self-limiting, TdP carries a risk of degenerating into ventricular fibrillation.

Conclusions:

  • Torsade de pointes is a critical condition requiring prompt recognition.
  • Understanding the causes of QT prolongation is key to prevention.
  • Effective management strategies are essential to mitigate risks associated with this arrhythmia.

Keywords:
Heart rhythm disordersHerzrhythmusstörungenLong-QTTorsade de pointesventricular tachycardiaventrikuläre Tachykardie

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