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EKG — Torsades de Pointe


Torsades de Pointe:

• A form of polymorphic ventricular tachycardia associated with prolonged QT intervals
• Onset is dependent on a pause in electrical activity brought on by a longer cycle length
• Often ends spontaneously but can degenerate
• Acquired causes include hypokalemia, cardiac disease, and drugs
• Methadone prolongs QT, can cause Torsades de Pointe
• Therapy depends on patient status:
– Defibrillation if ventricular fibrillation ensues
– 2 grams of magnesium
– Potassium should be given
– Overdrive pacing can be used
– Isoproterenol if the rate is very slow


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