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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.
An important differential diagnosis is torsades de pointes. [1] Treatment is with cardiopulmonary resuscitation (CPR) and defibrillation. [3] Biphasic defibrillation may be better than monophasic. [3] The medication epinephrine or amiodarone may be given if initial treatments are not effective. [1]
The core algorithm of ALS that is invoked when cardiac arrest has been confirmed, Advanced Cardiac Life Support (ACLS), relies on the monitoring of the electrical activity of the heart on a cardiac monitor. Depending on the type of cardiac arrhythmia, defibrillation and/or medication may be administered.
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]
Pediatric advanced life support (PALS) is a course offered by the American Heart Association (AHA) for health care providers who take care of children and infants in the emergency room, critical care and intensive care units in the hospital, and out of hospital (emergency medical services (EMS)).
Defibrillation [21] — Defibrillation is the definitive treatment step for those cases of cardiac arrest that involve a shockable rhythm, or one correctable by defibrillation (pulseless unstable ventricular tachycardia, coarse or fine ventricular fibrillation; it will not work for asystole or pulseless electrical activity)
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.