Quick Answer: What Can Cause Torsades?

How can torsades de pointes be prevented?

The first step in managing Torsades de Pointes is preventing its onset by targeting modifiable risk factors.

This includes discontinuing any QT prolonging drugs and optimizing a patient’s electrolyte profile.

Correcting hypokalemia, hypomagnesemia, and hypocalcemia can all help to prevent the onset of torsades..

What is the treatment for torsades?

Treatment of torsade de pointes includes: isoproterenol infusion, cardiac pacing, and intravenous atropine. Intravenous magnesium sulfate, a relatively new mode of therapy for torsade de pointes, was proven to be extremely effective and is now regarded as the treatment of choice for this arrhythmia.

What medications should be avoided with long QT syndrome?

Table 1Drugs to be avoided in patients with c-long QT syndromeAnti-depressantMirtazapine, Citalopram, Venlafaxine, Paroxetine, Fluoxetine, Sertraline, Trazodone, Escitalopram, Clomipramine, Amitriptyline, Imipramine, Nortriptyline, Desipramine, Doxepin, Trimipramine, Protriptyline48 more rows•Apr 26, 2013

What are the 3 shockable rhythms?

Shockable Rhythms: Ventricular Tachycardia, Ventricular Fibrillation, Supraventricular Tachycardia.

Can amiodarone cause torsades?

The causes of amiodarone-induced torsade de pointes are multifactorial, with electrolyte disturbances and concomitant medication with other QT-prolonging agents being the most common risk factors. In our patient, hypokalemia was considered a significant contributing factor to torsade de pointes.

What causes Torsades de Pointes?

Common causes for torsades de pointes include drug-induced QT prolongation and less often diarrhea, low serum magnesium, and low serum potassium or congenital long QT syndrome. It can be seen in malnourished individuals and chronic alcoholics, due to a deficiency in potassium and/or magnesium.

What drugs can cause Torsades de Pointes?

DRUGS THAT CAUSE QT PROLONGATION AND/OR TORSADES DE POINTESAntiarrhythmics. … Antihistamines. … Antimicrobials. … Tricyclic antidepressants. … Neuroleptics. … Prokinetics. … Other QT prolonging drugs that have been withdrawn.

What are the symptoms of torsade de pointes?

Symptoms of torsades de pointes include:heart palpitations.dizziness.nausea.cold sweats.chest pain.shortness of breath.rapid pulse.low blood pressure.

Why is magnesium used for torsades?

Magnesium is the drug of choice for suppressing early afterdepolarizations (EADs) and terminating the arrhythmia. Magnesium achieves this by decreasing the influx of calcium, thus lowering the amplitude of EADs. Magnesium can be given at 1-2 g IV initially in 30-60 seconds, which then can be repeated in 5-15 minutes.

Do you defibrillate torsades?

Torsades de pointes is a ventricular tachycardia. In the unstable patient, cardiovert. In the pulseless, defibrillate. (The polymorphic nature of the rhythm may interfere with the defibrillator’s ability to synchronize, so cardioversion may not be possible.

Is polymorphic v tach the same as torsades?

Torsades de pointes (TdP) is a specific form of polymorphic ventricular tachycardia occurring in the context of QT prolongation; it has a characteristic morphology in which the QRS complexes “twist” around the isoelectric line.

Does a pacemaker prevent torsades?

While implantable cardiac devices are given to patients with long QT syndrome and other arrhythmias, there is no data on their use to prevent medication-induced torsades. The pacemaker component of such devices should in theory help prevent torsades by preventing bradycardia.