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Torsades de Pointes

A characteristic polymorphic ventricular tachycardia arising on the background of a long QT interval.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

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What is Torsades de Pointes?

Torsades de pointes (TdP), French for 'twisting of the points', describes a polymorphic ventricular tachycardia in which the QRS complexes appear to rotate around the isoelectric line. It typically develops on a background of prolonged QT interval (congenital or acquired).

Common causes include antiarrhythmics (sotalol, amiodarone, quinidine), antipsychotics, antibiotics (macrolides, fluoroquinolones), antiemetics, hypokalemia, hypomagnesemia and bradycardia. Congenital long QT syndromes also predispose to TdP.

TdP can degenerate into ventricular fibrillation and cause sudden cardiac death. Emergency treatment is intravenous magnesium sulfate (2 g bolus); overdrive pacing or isoproterenol are used for bradycardia. Discontinuation of QT-prolonging drugs and correction of electrolytes are essential.

Symptoms

Sudden palpitations
Presyncope and syncope
Dizziness
Chest pain
Dyspnea
Sudden cardiac arrest
Convulsions from cerebral hypoperfusion

Risk Factors

Congenital long QT syndrome
QT-prolonging drugs (antiarrhythmics, antibiotics, antipsychotics)
Hypokalemia and hypomagnesemia
Bradycardia
Female sex
Advanced age
Structural heart disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Syncope with palpitations
  • Syncope while on a QT-prolonging drug
  • Family history of sudden cardiac death
  • QT prolongation on ECG
  • Recurrent presyncope
  • After events requiring resuscitation

Treatment Methods

01
Emergency intravenous magnesium sulfate (first line)
02
Discontinuation of QT-prolonging drugs
03
Correction of electrolyte disturbances
04
Overdrive pacing or isoproterenol for bradycardia
05
Defibrillation for hemodynamic instability
06
ICD implantation in recurrent cases
07
Beta-blockers in congenital long QT

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.