cardiovascular disorders
Torsades de Pointes Ventricular Tachycardia
Treatment of Torsades de Pointes Ventricular Tachycardia
Unsynchronized direct current cardioversion for ventricular fibrillation Correction of electrolyte abnormalities, especially hypokalemia Magnesium sulfate (MgSO4) IV Treatments to increase basal heart rate, including pacing or IVisoproterenol Treatment of cause An acute episode prolonged enough to cause hemodynamic compromise is treated with Defibrillation , beginning with 100 joules. Nevertheless, early recurrence is the rule. Electrolyte abnormalities (eg, If a drug is the cause, it is stopped, but until drug clearance is complete, patients with frequent or long runs of torsades de pointes ventricular tachycardia require treatment to shorten the QT interval. Because increasing the heart rate shortens the QT interval, temporary pacing, IVisoproterenol, or both are often effective. Increasing heart rate will also shorten the “long” in the “short-long-short” initiation sequences of TdeP VT. Long-term treatment is avoidance of conditions that prolong the QT interval. Some patients with an acquired long QT-interval syndrome have an underlying subclinical congenital long QT-interval syndrome suggested by persistent QTc interval prolongation after removal of exogenous QTc prolonging influences. 