Diagnosis and treatment

Torsades de pointes

Torsades de pointes
  • MgSO4 2g i.v. to be repeated every 15 minutes.
  • Stop all medication (anti-arrhythmic, anti-depressive drugs) extending QT interval.
  • Eventually temporary pacemaker.
  • In long QT interval and bradycardia consider heart rate acceleration with isoprenalin (Isuprel - dilute 5 doses in 250 ml of NaCL or G5% - monitor to obtain HR > 90 bpm)