Difference between revisions of "Torsades de pointes"

(Treatment)
(Content change)
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==Treatment==
 
==Treatment==
#Magnesium
+
Increasing HR decreases QT interval
##1-2gm IV over 1-2 min; then 1-2gm/hr gtt
+
#Magnesium - decreases calcium influx
#[[Overdrive Pacing]]
+
##1-2gm IV over 1-2 min, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) gtt
 +
###Danger of hyperMag2+ → depressed neuromuscular function
 +
###Supplement with K+
 +
#Isoproterenol - Increases HR / AV conduction
 +
##2-8 mcg/min
 +
#[[Overdrive Pacing]] - Atrial over ventricular pacing
 
##Goal HR 90-120
 
##Goal HR 90-120
#Isoproterenol
 
##2-8 mcg/min
 
  
 
==See Also==
 
==See Also==

Revision as of 04:44, 8 January 2014

Background

  • Most commonly occurs in pts w/ prolonged QT due to heart diseaes or meds:
    • Procainamide
    • Phenothiazine
    • TCAs
    • Qunidine
    • Disopyramide

Treatment

Increasing HR decreases QT interval

  1. Magnesium - decreases calcium influx
    1. 1-2gm IV over 1-2 min, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) gtt
      1. Danger of hyperMag2+ → depressed neuromuscular function
      2. Supplement with K+
  2. Isoproterenol - Increases HR / AV conduction
    1. 2-8 mcg/min
  3. Overdrive Pacing - Atrial over ventricular pacing
    1. Goal HR 90-120

See Also

Source

  • Tintinalli