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A practical approach to torsade de pointes

D M Roden1

  • 1Vanderbilt University School of Medicine, Department of Medicine, Nashville, Tennessee 37232-6602, USA.

Clinical Cardiology
|March 1, 1997
PubMed
Summary
This summary is machine-generated.

Torsade de pointes is a dangerous heart rhythm linked to a prolonged QT interval, often caused by medications. Treatment involves identifying the cause, correcting electrolyte imbalances, and using therapies like magnesium or pacing.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Torsade de pointes is a specific type of polymorphic ventricular tachycardia.
  • It is characterized by an abnormally prolonged QT interval on an electrocardiogram.
  • Common causes include QT-prolonging drugs, congenital long QT syndromes, heart block, and electrolyte disturbances like hypokalemia.

Purpose of the Study:

  • To review the causes, electrocardiographic features, and management of torsade de pointes.
  • To highlight the role of both cardiac and non-cardiac medications in drug-induced torsade de pointes.

Main Methods:

  • Literature review of torsade de pointes.
  • Analysis of electrocardiographic findings.
  • Summary of treatment strategies.

Main Results:

  • Torsade de pointes is associated with labile QT intervals, prominent U waves, and pause-dependent onset.
  • Both antiarrhythmic and "non-cardioactive" drugs can precipitate this arrhythmia.
  • Correction of electrolyte abnormalities and drug withdrawal are crucial.

Conclusions:

  • Prompt recognition and management are vital for torsade de pointes.
  • Magnesium, isoproterenol, and cardiac pacing are effective treatments.
  • Understanding drug-induced torsade de pointes is essential for patient safety.