Torsade de Pointes: Difference between revisions

Torsade de Pointes (view source)

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 '''Treatment'''<cite>ACC</cite>
-* Withdrawal of any offending drugs and correction of electrolyte abnormalities.
+* Withdrawal of any offending drugs and correction of electrolyte abnormalities (potassium repletion up to 4.5 to 5 mmol/liter).
 * Acute and long-term cardiac pacing in patients with TdP presenting with heart block and symptomatic bradycardia.<cite>Eldar</cite>
-The guidelines suggest that the weight of evidence supports the following (weaker recommendations):
 * Intravenous magnesium sulfate for patients with QT prolongation and few episodes of TdP.
 * Acute and long-term cardiac pacing for patients who have recurrent, pause-dependent TdP.
 * Beta blockers combined with cardiac pacing as acute therapy for patients with TdP and sinus bradycardia.
 * Isoproterenol as temporary treatment in patients with recurrent pause-dependent TdP who do not have congenital long QT syndrome.
-The guidelines also suggest that the following interventions may be considered, although supporting evidence is less well-established:
-* Potassium repletion to 4.5 to 5 mmol/liter.
-* For patients with long QT syndrome 3 (LQT3) and TdP, intravenous lidocaine or oral mexiletine.
 There has been much debate in the ''Circulation'' journal among French and American scientist whether one should write ''Torsades de Pointes'' or ''Torsade de Pointes''. As for now ''Torsade'' is prefered (unless one sees rotations around more than one axis in one episode), but both forms are used in similar frequency.<cite>Moise</cite>
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 #Khan pmid=11330748
 #Eldar pmid=3624666
-#ACC pmid=16949511
+#ACC pmid=16923744
 </biblio>
 ==External Links==