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Torsades de pointes, torsade de pointes or torsades des pointes (TdP; also called torsades) (/ t ɔːr ˌ s ɑː d d ə ˈ p w æ̃ t /, [2] French: [tɔʁsad də pwɛ̃t̪], translated as "twisting of peaks") is a specific type of abnormal heart rhythm that can lead to sudden cardiac death.
Advanced cardiac life support, advanced cardiovascular life support (ACLS) refers to a set of clinical guidelines established by the American Heart Association (AHA) for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest, using advanced medical procedures, medications, and techniques.
Treatment for this condition includes activated charcoal and sodium bicarbonate. [120] Magnesium can be given at a does of 2 g (iv or oral bolus) to manage torsades de points. However, without specific indication, magnesium is not generally given in cardiac arrest. [121]
Hypokalemia is an important cause of acquired long QT syndrome, and may predispose the patient to torsades de pointes. Digitalis use may increase the risk that hypokalemia will produce life-threatening arrhythmias. Hypokalemia is especially dangerous in patients with ischemic heart disease. [citation needed]
Recent research suggests that a nonsurgical treatment, including physical therapy, could be as effective, sparking controversy among surgeons who perform dozens of ACL reconstructions every year.
The term ventricular arrhythmia refers to the group of abnormal cardiac rhythms originating from the ventricle, which includes ventricular tachycardia, ventricular fibrillation, and torsades de pointes. [2] In those who have normal blood pressure and strong pulse, the antiarrhythmic medication procainamide may be used. [2]
Early afterdepolarizations can result in torsades de pointes, tachycardia, and other arrhythmias. [3] EADs can be triggered by hypokalemia and drugs that prolong the QT interval, including class Ia and III antiarrhythmic agents, as well as catecholamines. [1] Afterhyperpolarizations can also occur in cortical pyramidal neurons.
It is also used to prevent Torsades de Pointes in patients with long QT refractory to magnesium and to treat patients with intermittent Torsades de Pointes refractory to treatment with magnesium. [16] Isoprenaline is used in the acute management of bradycardia, though not in the chronic treatment of bradycardia. [17]