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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.
Compounds that prolong the action potential: matching the modern classification, with the key drug example being amiodarone, and a surgical example being thyroidectomy. This was not a defining characteristic in an earlier review by Charlier et al. (1968), [ 17 ] but was supported by experimental data presented by Vaughan Williams (1970).
Excessive QT prolongation can trigger tachycardias such as torsades de pointes (TdP). QT prolongation is an established side effect of antiarrhythmics, but can also be caused by a wide range of non-cardiac medicines, including antibiotics, antidepressants, antihistamines, opioids, and complementary medicines.
Amiodarone is also safe to use in individuals with cardiomyopathy and atrial fibrillation, to maintain normal sinus rhythm. Amiodarone prolongation of the action potential is uniform over a wide range of heart rates, so this drug does not have reverse use-dependent action. Amiodarone was the first agent described in this class. [4]
Amiodarone has been used both in the treatment of acute life-threatening arrhythmias as well as the long-term suppression of arrhythmias. [13] Amiodarone is commonly used to treat different types of abnormal heart rhythms, such as atrial arrhythmias (supraventricular arrhythmias) and ventricular arrhythmias. [13]
AZCERT focuses on drugs and drug–drug interactions, especially those that cause QT prolongation and Torsades de Pointes (TdP) arrhythmia, and provides its research and its lists of drugs [10] free of charge to the public, healthcare providers, and researchers for personal, professional, and non-commercial purposes. To maintain the ...
Evidence does not show that amiodarone is better than procainamide. [16] As a low magnesium level in the blood is a common cause of VT, magnesium sulfate can be given for torsades de pointes or if a low blood magnesium level is found/suspected. [citation needed] Long-term anti-arrhythmic therapy may be indicated to prevent recurrence of VT.
Liver or lung toxicity related to the previous use of amiodarone [2] Severe hepatic impairment [2] QTc Bazett interval ≥500 ms, [2] or use with drugs or herbal supplements that prolong QT interval or increase risk of torsades de points (Class I or III antiarrhythmic agents, phenothiazines, tricyclic antidepressants, certain oral macrolides ...
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