Question: What Is The Cause Of Torsades De Pointes?

How common is Torsades de Pointes?

Torsades de pointes is more common in women than men, but anyone can develop the condition.

It is usually a complication of LQTS, which can be drug-induced or congenital, meaning the person is born with it..

Why is magnesium used for torsades?

Magnesium is the drug of choice for suppressing early afterdepolarizations (EADs) and terminating the arrhythmia. Magnesium achieves this by decreasing the influx of calcium, thus lowering the amplitude of EADs. Magnesium can be given at 1-2 g IV initially in 30-60 seconds, which then can be repeated in 5-15 minutes.

What are the 3 shockable rhythms?

Shockable Rhythms: Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular Tachycardia.

Is polymorphic v tach the same as torsades?

Polymorphic ventricular tachycardia Defined as ventricular tachycardia with varying QRS amplitude. This is commonly referred to as torsades de pointes, but it’s actually not the same thing.

Why do doctors give magnesium?

Magnesium helps maintain a normal heart rhythm and doctors sometimes administer it intravenously (IV) in the hospital to reduce the chance of atrial fibrillation and cardiac arrhythmia (irregular heartbeat). People with congestive heart failure (CHF) are often at risk for developing cardiac arrhythmia.

What does magnesium sulfate do to the heart?

magnesium sulphate. The major findings of this study were that magnesium sulphate, in a dose-dependent manner, lowered systemic vascular resistance, arterial pressure and heart rate, while cardiac output was well maintained.

Can amiodarone cause torsades?

4 Amiodarone is presumed to have a low incidence of drug-induced torsades de pointes (TdP) with an incidence of <0.5%.

What drugs can cause Torsades de Pointes?

Other drugs that prolong the QT interval and have been implicated in cases of torsade include phenothiazines, tricyclic antidepressants, lithium carbonate, ziprasidone, cisapride, highly active antiretroviral drugs, high-dose methadone, anthracycline chemotherapeutic agents (eg, doxorubicin, daunomycin), some …

How can torsades de pointes be prevented?

The first step in managing Torsades de Pointes is preventing its onset by targeting modifiable risk factors. This includes discontinuing any QT prolonging drugs and optimizing a patient’s electrolyte profile. Correcting hypokalemia, hypomagnesemia, and hypocalcemia can all help to prevent the onset of torsades.

What does torsades feel like?

You may suddenly feel your heart beating faster than normal, even when you’re at rest. In some TdP episodes, you may feel light-headed and faint. In the most serious cases, TdP can cause cardiac arrest or sudden cardiac death. It’s also possible have an episode (or more than one) that resolves quickly.

Does a pacemaker prevent torsades?

The pacemaker component of such devices should in theory help prevent torsades by preventing bradycardia. However, the rate of most pacemakers is not likely to provide protection from torsades.

Do you defibrillate torsades?

Torsades de pointes is a ventricular tachycardia. In the unstable patient, cardiovert. In the pulseless, defibrillate. (The polymorphic nature of the rhythm may interfere with the defibrillator’s ability to synchronize, so cardioversion may not be possible.

Why would you need magnesium drip?

Intravenous or injected magnesium is used to treat certain conditions, such as eclampsia during pregnancy and severe asthma attacks.

What is the treatment for torsades?

The long QT interval responsible for torsades de pointes ventricular tachycardia can be congenital or drug-induced. Immediate treatment of torsades is unsynchronized cardioversion beginning with 100 joules, although some patients respond to magnesium sulfate 2 g IV over 1 to 2 minutes.

Is torsades VT or VF?

Frequent PVCs with ‘R on T’ phenomenon trigger a run of polymorphic VT which subsequently begins to degenerate to VF. QT is difficult to see because of artefact but appears slightly prolonged (QTc ~480ms), making this likely to be TdP.

What are the 5 lethal cardiac rhythms?

You will learn about Premature Ventricular Contractions, Ventricular Tachycardia, Ventricular Fibrillation, Pulseless Electrical Activity, Agonal Rhythms, and Asystole.