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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.
The term "torsades de pointes" is translated from French as "twisting of the peaks" because the complexes appear to undulate, or twist around, the EKG baseline. TdP can be acquired by inheritance of a congenital long QT syndrome , or more commonly from the ingestion of a pharmacologic drug.
Torsades de pointes is the most serious side effect of dofetilide therapy. The incidence of torsades de pointes is 0.3-10.5% and is dose-related, with increased incidence associated with higher doses. The majority of episodes of torsades de pointes have occurred within the first three days of initial dosing.
Torsades de pointes: 2 points T-wave alternans: 1 point Notched T-waves in at least 3 leads 1 point Low heart rate for age (children) 0.5 points Syncope with stress 2 points Cannot receive points both for syncope and Torsades without stress 1 point Congenital deafness 0.5 points Family history Other family member with confirmed LQTS 1 point
It is also used in the treatment of torsades de pointes, severe asthma exacerbations, constipation, and barium poisoning. [1] [2] It is given by injection into a vein or muscle as well as by mouth. [1] [2] As epsom salts, it is also used for mineral baths. [3] Common side effects include low blood pressure, skin flushing, and low blood calcium. [1]
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.
These are typically a form of ventricular tachycardia known as Torsades de pointes which can cause faints, seizures, or even sudden death. [1] Less dangerous arrhythmias such as atrial fibrillation also occur, causing symptoms of heart racing or palpitations. However, many of those with Romano–Ward syndrome will remain free from arrhythmias ...
Pimozide overdose presents with severe extrapyramidal symptoms, hypotension, sedation, QT interval prolongation and ventricular arrhythmias including torsades de pointes. [7] Gastric lavage, establishment of a patent airway and, if necessary, mechanically assisted respiration is the recommended treatment for pimozide overdose. [7]