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Torsades de pointes

Torsades de pointes

Torsades de pointes ('twisting of the points') is a form of polymorphic ventricular tachycardia associated with a long QT interval. It may deteriorate into ventricular fibrillation and hence lead to sudden death.

Causes of long QT interval
  • congenital
    • Jervell-Lange-Nielsen syndrome
    • Romano-Ward syndrome
  • antiarrhythmics: amiodarone, sotalol, class 1a antiarrhythmic drugs
  • tricyclic antidepressants
  • antipsychotics
  • chloroquine
  • terfenadine
  • erythromycin
  • electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia
  • myocarditis
  • hypothermia
  • subarachnoid haemorrhage

Management
  • IV magnesium sulphate

ECG showing torsades de pointes
+PassMedicine Notes

Torsades de pointes ('twisting of the points') is a form of polymorphic ventricular tachycardia associated with a long QT interval. It may deteriorate into ventricular fibrillation and hence lead to sudden death.

Causes of long QT interval
  • congenital
    • Jervell-Lange-Nielsen syndrome
    • Romano-Ward syndrome
  • antiarrhythmics: amiodarone, sotalol, class 1a antiarrhythmic drugs
  • tricyclic antidepressants
  • antipsychotics
  • chloroquine
  • terfenadine
  • erythromycin
  • electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia
  • myocarditis
  • hypothermia
  • subarachnoid haemorrhage
Management
  • IV magnesium sulphate
ecg069.png ECG showing torsades de pointes

Media
Long QT syndrome & torsade de pointes
Osmosis - YouTube
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Life in the Fast Lane
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Torsades de pointes
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