torsade de pointes

tor·sade de pointes

(tōr-sad' dĕ pwant'), This word, referring not to individual QRS complexes but to an overall pattern of variation in their form, is properly used in the singular, not the plural (torsades de pointes).
"Twisting of the points," a form of ventricular tachycardia nearly always due to medications and characterized by a long QT interval and a "short-long-short" sequence in the beat preceding its onset. The QRS complexes during this rhythm tend to show a series of complexes points up followed by complexes points down, often with a narrow waist between and no definite T waves; at one time referred to as "cardiac ballet."
[Fr. torsade, fringe, twist, or coil, + pointe, point or tip (euphonious for "wave burst")]

torsade de pointes

French, torsade–twist, Cardiology A form of polymorphic ventricular tachycardia with prolonged Q-T intervals initiated by a premature ventricular depolarization striking near the apex of a delayed T wave; torsades have irregular rates of 200-250/min with marked variability in amplitude and direction of a QRS wave that seems to twist around an isoelectric baseline; torsades may spontaneously resolve or evolve to ventricular tachyarrhythmia and may be nonspecific or due to drugs–eg, adrenergics, antihistamine, phenothiazine, procainamide, quinines, sotalol, and tricyclic antidepressants, electrolyte imbalance–eg, hypokalemia, hypomagnesemia, CNS hemorrhage or trauma, long Q-T wave syndrome, liquid diet, and underlying heart disease Management Isoproterenol.

tor·sade de pointes

(tōr-sahd' dĕ pwahnt')
Literally, "twisting of points," a form of ventricular tachycardia nearly always due to medications and characterized by a long QT interval and a "short-long-short" sequence in the beat preceding its onset. The QRS complexes during this rhythm tend to show a series of complexes points up followed by complexes points down, often with a narrow waist between.
[Fr. torsade, fringe, twist, or coil, + pointe, point or tip]

torsade de pointes

(tor-sad'de pwont')
A rapid, unstable form of ventricular tachycardia in which the QRS complexes appear to twist, or shift, electrical orientation around the isoelectric line of the electrocardiogram. It often occurs as a life-threatening effect of a medication (such as quinidine, amiodarone, or a tricyclic antidepressant) that prolongs the Q-T interval but may also complicate congenital long QT syndromes. Intravenous magnesium sulfate may be used to treat this arrhythmia.
Synonym: polymorphic ventricular tachycardia
References in periodicals archive ?
The longer a QT interval, typically measured by an electrocardiogram, the more at risk a person is to develop serious heart rhythm problems and a condition called torsade de pointes, which can result in sudden death.
Las interacciones farmacologicas de medicamentos con carga anticolinergica moderada y alta, inducen a un mayor riesgo de cardiotoxicidad, debido a la prolongacion del QTc (intervalo Qt corregido), lo que podria llevar a torsade de pointes (TdP), especialmente por antidepresivos triciclicos y antipsicoticos atipicos en combinacion con otros medicamentos con carga anticolinergica, como los antiparkinsonianos (Amantadina), antibioticos y antihistaminicos (34, 35).
It is noted that much higher than recommended doses of loperamide, either intentionally or unintentionally, can result in serious cardiac adverse events, including QT interval prolongation, torsade de pointes or other ventricular arrhythmias, syncope, and cardiac arrest.
Several case reports showed that donepezil could lead rarely to serious bradycardia needing pacemaker implantation and fatal ventricular arrhythmia (torsade de pointes (TdP)) [7,8].
In our study, 3.15% patients were having severe hypomagnesaemia and all of these patients have torsade de pointes as the presenting arrhythmia suggesting that severe hypomagnesaemia is an important cause of torsade de pointes.
Persons with long QT syndrome (autosomal disorder with population frequency of 1:5000) are predisposed to peak torsade (torsade de pointes).
Electrocardiography abnormalities such as atrial flutter, atrioventricular block, torsade de pointes, sinus tachycardia, QT prolongation, ST elevation, and T wave inversion were detected in seven patients.
Sertindole was never marketed in the US [6]; mesoridazine was marketed in the US but with a warning regarding dose-related QTc prolongation and associated risk of torsade de pointes [6].
While the risk of drug-induced prolonged QT and the incidence of possible lethal Torsade de Pointes (TdP) arrhythmias are generally low with an annually reported rate of 0.8 to 1.2 per million persons years (reviewed in [6]), a recent study from Germany found the reported rate to be increasing from 0.26 to 2.5 and 4.0 per million per year in males and females, respectively, due to active surveillance [7].
Cardiac conduction defects or arrhythmias preceding SCD in KSS patients include QT-prolongation, Torsade de pointes, or polymorphic ventricular tachycardia.
A family history of sudden cardiac death or syncope should be sought when a familial cause is suspected (torsade de pointes with the congenital long QT syndrome and VT or PVCs with arrhythmogenic right ventricular cardiomyopathy (ARVC)).
Patients should be counseled to avoid the drugs that cause further prolongation of QT interval or periodic Torsade de pointes. Intense physical activity, sports and emotional stress should be avoided.