What is torsade de pointes?

Updated: Jan 31, 2017
  • Author: Jatin Dave, MD, MPH; Chief Editor: Mikhael F El-Chami, MD  more...
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Answer

Answer

Torsade de pointes is an uncommon and distinctive form of polymorphic ventricular tachycardia (VT) characterized by a gradual change in the amplitude and twisting of the QRS complexes around the isoelectric line (see the image below). Torsade de pointes, often referred to as torsade, is associated with a prolonged QT interval, which may be congenital or acquired. Torsade usually terminates spontaneously but frequently recurs and may degenerate into ventricular fibrillation.

Torsade de pointes. Asymptomatic patient on erythr Torsade de pointes. Asymptomatic patient on erythromycin had marked QT prolongation on ECG findings. Patient was profoundly hypomagnesemic and hypokalemic. This shows an example of recurrent nonsustained torsade de pointes that occurred several hours after the ECG was performed. With discontinuation of the erythromycin and aggressive repletion of the magnesium and potassium, no further torsade de pointes occurred and the patient's QT interval returned to normal.

In torsade, the morphology of the QRS complexes varies from beat to beat. The ventricular rate can range from 150 beats per minute (bpm) to 250 bpm.


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