569:, which may promote triggered activity. Re-entry, due to a dispersion of refractory periods, is also possible; this is because M Cells (found in the mid myocardial layer) show a more prolonged repolarization phase in response to potassium blockage than other cells. In turn, this produces a zone of functional refractoriness (inability to depolarize) in the mid myocardial layer. When new action potential is generated, the mid myocardial layer will remain in a refractory period, but the surrounding tissue will depolarize. As soon as the mid myocardial layer is no longer in a refractory period, excitation from nearby tissue will cause a retrograde current and a reentry circuit that will result in a positive chronotropic cycle, leading to tachycardia.
439:
53:
1862:"2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC)"
649:. It's considered a cardiac arrhythmia in which the ventricles of the heart become again excited during the repolarization of the previous heart action. Because part of the heart muscle cannot be excited at this early point in time, a premature chamber action can trigger life-threatening cardiac arrhythmias (e.g. ventricular fibrillation or Torsades de pointes).
797:
but lists the singular as a variant, and yet another enters the singular form as the headword and gives a usage comment saying that the plural is not preferred. One group of physicians has suggested that it would make the most sense to use the singular form to refer to the arrhythmia entity (where an
581:
with a characteristic illusion of a twisting of the QRS complex around the isoelectric baseline (peaks, which are at first pointing up, appear to be pointing down for subsequent "beats" when looking at ECG traces of the "heartbeat"). It is hemodynamically unstable and causes a sudden drop in arterial
1156:
Drew, Barbara J.; Ackerman, Michael J.; Funk, Marjorie; Gibler, W. Brian; Kligfield, Paul; Menon, Venu; Philippides, George J.; Roden, Dan M.; Zareba, Wojciech; American Heart
Association Acute Cardiac Care Committee of the Council on Clinical Cardiology; Council on Cardiovascular Nursing; American
546:
Calcium channels close (inward Ca stops), but potassium channels are still open (outward K current); this persists until the cells gain back normal polarization (repolarization achieved). Please note that phase 0 leads to a net gain of Na, while phases 1â3 lead to a net loss of K. This imbalance is
561:
Repolarization of the cardiomyocytes occurs in phases 1â3, and is caused predominantly by the outward movement of potassium ions. In
Torsades de pointes, however, the repolarization is prolonged; this can be due to electrolyte disturbances (hypokalemia, hypomagnesemia, hypocalcemia), bradycardia,
353:
Knowledge that TdP may occur in patients taking certain prescription drugs has been both a major liability and reason for removal of 14 medications from the marketplace. Forty-nine drugs known to cause TdP and another 170 that are known to prolong QT remain on the market because the drugs provide
793:) have all often been used. The question of whether each one is grammatically "correct" and the others "incorrect" has repeatedly arisen. This is seen among major medical dictionaries, where one enters only the plural form, another enters the plural form as the
914:
Pickham, David; Helfenbein, Eric; Shinn, Julie A.; Chan, Garrett; Funk, Marjorie; Weinacker, Ann; Liu, Jia-Ni; Drew, Barbara J. (2012). "High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality".
600:, wherein the R-wave, representing ventricular depolarization, occurs during the relative refractory period at the end of repolarization (represented by the latter half of the T-wave). An R-on-T can initiate torsades. Sometimes, pathologic
422:(Propulsid) was withdrawn from the US market in 2000 after it was linked to deaths caused by long QT syndrome-induced torsades de pointes. This effect can be directly linked to QT prolongation mediated predominantly by inhibition of the
798:
arrhythmia may involve one or multiple episodes), and that one might best reserve the plural form for describing repeated twisting during a single episode. Other authors have suggested all three words should be plural. Regarding the
1859:
Priori, Silvia G.; Blomström-Lundqvist, Carina; Mazzanti, Andrea; Blom, Nico; Borggrefe, Martin; Camm, John; Elliott, Perry Mark; Fitzsimons, Donna; Hatala, Robert; Hindricks, Gerhard; Kirchhof, Paulus (November 2015).
341:, can result in higher-than-normal levels of medications that prolong the QT interval in the bloodstream and therefore increase a person's risk of developing torsades de pointes. A TdP cardiac event precipitated by
1205:
Woosley, R. L., Heise, C. W., Gallo, T., Tate, J., Woosley, D., and K. A. Romero. www.CredibleMeds.org, QTdrugs List, Accessed 9 June 2019, AZCERT, Inc. 1822 Innovation Park Dr., Oro Valley, AZ
286:
Torsades occurs as both an inherited (linked to at least 17 genes) and as an acquired form caused most often by drugs and/or electrolyte disorders that cause excessive lengthening of the QT interval.
758:. In coining the term, he referred his colleagues to the "Dictionnaire Le Robert", a bilingual French English dictionary, of which his wife had just given him a copy. Here, "torsade" is defined as:
699:- a procedure in which an electrical current is applied across the heart to temporarily stop and then resynchronise the heart's cells. Treatment to prevent recurrent torsades includes infusion of
1009:
Saprungruang, Ankavipar; Khongphatthanayothin, Apichai; Mauleekoonphairoj, John; Wandee, Pharawee; Kanjanauthai, Supaluck; Bhuiyan, Zahurul A.; Wilde, Arthur A. M.; Poovorawan, Yong (2018).
641:
The R-on-T phenomenon is the superimposition of a premature ventricular contraction on the T wave of a preceding heart beat. Studies suggest that R-on-T phenomenon is likely to start a sustained
586:. Depending on their cause, most individual episodes of torsades de pointes revert to normal sinus rhythm within a few seconds; however, episodes may also persist and possibly degenerate into
547:
corrected by the Na/K-ATPase channel that pumps K into the cell and sodium out of the cell; this does not change polarization of the cells, but does restore ionic content to its initial state.
1813:
Hoshino, Kenji; Ogawa, Kiyoshi; Hishitani, Takashi; Isobe, Takeshi; Etoh, Yoshikatsu (2006). "Successful uses of magnesium sulfate for torsades de pointes in children with long QT syndrome".
660:) is superimposed during the repolarization phase of the previous action of the heart. Not all premature chamber actions can trigger these dangerous arrhythmias; the risk is increased with
354:
medical benefit and the risk of TdP can be managed and mitigated by instructions in the drug label. Examples of compounds linked to clinical observations of TdP include
557:
sinus node) will cause minor depolarization in the cells; this will result in increasing permeability of sodium channels, which trigger the opening of sodium channels.
120:
Medications, hypokalemia, hypomagnesemia, hypocalcemia, bradycardia, heart failure, left ventricular hypertrophy, hypothermia, subarachnoid hemorrhage, hypothyroidism
246:
can increase a person's risk of developing this abnormal heart rhythm, occurring in between 1% and 10% of patients who receive QT-prolonging antiarrhythmic drugs.
687:
The treatment of torsades de pointes aims to restore a normal rhythm and to prevent the arrhythmia recurring. While torsades may spontaneously revert to a normal
607:
A "short-coupled variant of torsade de pointes", which presents without long QT syndrome, was also described in 1994 as having the following characteristics:
2800:
1704:
Oksuz, Fatih; Sensoy, Baris; Sahan, Ekrem; Sen, Fatih; Baser, Kazım; Cetin, Hande; Unal, Sefa; Ozeke, Ozcan; Topaloglu, Serkan; Aras, Dursun (July 2015).
1301:
540:
Potassium channels remain open (outward current of K), and calcium channels now also open (inward current of Ca), resulting in a plateau state.
1615:"Short-coupled variant of torsade de pointes. A new electrocardiographic entity in the spectrum of idiopathic ventricular tachyarrhythmias"
2441:
601:
398:
may also increase the risk of developing TdP. It has also been shown as a side effect of certain anti-arrhythmic medications, such as
1909:
2131:
858:
528:
Sodium channels open, resulting in the entrance of Na into the cells; this results in the depolarization of the cardiac muscles.
2858:
2175:
724:
534:
Sodium channels close; this stops depolarization. Potassium channels open, leading to an outward current of K out of the cells.
447:
1435:
1277:
562:
certain drugs (disopyramide, sotalol, amiodarone, amitriptyline, chlorpromazine, erythromycin) and/or congenital syndromes.
2662:
2499:
2853:
2667:
2657:
2246:
457:
The following is a partial list of factors associated with an increased tendency towards developing torsades de pointes:
565:
The prolongation of repolarisation may result in subsequent activation of an inward depolarisation current, known as an
2964:
2795:
2409:
17:
2835:
1409:
653:
629:
1360:"Screening for Acute IKr Block is Insufficient to Detect Torsades de Pointes Liability: Role of Late Sodium Current"
2830:
754:
in 1966, when he observed this cardiac rhythm disorder in an 80-year-old female patient with complete intermittent
679:
In the Lown grading system of ventricular arrhythmias, the R-on-T phenomenon is the fifth, most threatening class.
594:, a condition whereby prolonged QT intervals are visible on an ECG. Long QT intervals predispose the patient to an
3219:
2699:
2480:
1098:
723:
may be used to accelerate the heart's own sinus rhythm, and those at risk of further torsades may be offered an
590:, leading to sudden death in the absence of prompt medical intervention. Torsades de pointes is associated with
2775:
2770:
2694:
1219:
Champeroux, P.; Viaud, K.; El Amrani, A. I.; Fowler, J. S.; Martel, E.; Le
Guennec, J. Y.; Richard, S. (2005).
1511:
Napolitano, C.; Priori, S. G.; Schwartz, P. J. (1994-01-01). "Torsade de pointes. Mechanisms and management".
3121:
2997:
2926:
2758:
2494:
3116:
2909:
2892:
2825:
2745:
2124:
734:. By blocking the calcium channels in phase 2 of the myocardial action potential, magnesium suppresses the
720:
708:
495:
338:
310:
305:, due to a deficiency in potassium and/or magnesium. Certain drugs and combinations of drugs resulting in
3214:
2959:
2404:
625:
Preceded by long and short RR-intervals - not present in the short-coupled variant of torsade de pointes
2941:
2429:
2414:
2488:
1358:
Yang, T.; Chun, Y. W.; Stroud, D. M.; Mosley, J. D.; Knollmann, B. C.; Hong, C.; Roden, D. M. (2014).
1315:
Lenz T. L.; Hilleman D. E. (July 2000). "Dofetilide, a New Class III Antiarrhythmic Agent".
3019:
2716:
2684:
2611:
2338:
958:
Groot, Jan Albert
Nicolaas; Ten Bokum, Leonore; Van Den Oever, Hubertus Laurentius Antonius (2018).
844:
3143:
2969:
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2689:
2586:
2567:
2397:
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2043:
960:"Late presentation of Torsades de Pointes related to fluoxetine following a multiple drug overdose"
646:
587:
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3126:
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2787:
2591:
2572:
2224:
2164:
2117:
1221:"Prediction of the risk of Torsade de Pointes using the model of isolated canine Purkinje fibres"
731:
661:
642:
505:
231:
89:
1658:
876:
730:
Magnesium is used in the treatment of torsades de pointes because it functions as a physiologic
345:
has been reported (although the dose was well beyond the therapeutic range of the medication).
239:
2765:
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1564:"Torsade de Pointes due to Methadone Use in a Patient with HIV and Hepatitis C Coinfection"
367:
275:
227:
1613:
Leenhardt A, Glaser E, Burguera M, NĂŒrnberg M, Maison-Blanche P, Coumel P (January 1994).
1562:
John, J.; Amley, X.; Bombino, G.; Gitelis, C.; Topi, B.; Hollander, G.; Ghosh, J. (2010).
1272:. Sanoski, Cynthia A.,, Deglin, Judith Hopfer, 1950- (Fourteenth ed.). Philadelphia.
823:
762:
a bundle of threads, twisted in a helix or spiral, for ornamental purposes (such as in an
289:
Common causes for torsades de pointes include drug-induced QT prolongation and less often
8:
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2006:
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or congenital long QT syndrome. It can be seen in malnourished individuals and chronic
271:
1426:
Davidson, Sir
Stanley (2010). Colledge, Nicki; Walker, Brian; Ralston, Stuart (eds.).
1375:
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variation, they concluded, in good nature, "Wasn't it the French who coined the term
700:
443:
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235:
77:
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1344:
1107:"Loperamide Induced Torsades de Pointes: A Case Report and Review of the Literature"
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2001:
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162:
108:
2097:
1011:"Genotype and clinical characteristics of congenital long QT syndrome in Thailand"
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1413:
928:
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1328:
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1955:
1938:
1758:"Pharmacological treatment of acquired QT prolongation and torsades de pointes"
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1996:
1939:"As Americans, we should get this right [correspondence and response]"
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to automatically detect and defibrillate further episodes of the arrhythmia.
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2015:
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936:
859:"TORSADE DE POINTES | Meaning & Definition for UK English | Lexico.com"
763:
712:
703:, correction of electrolyte imbalances such as low blood potassium levels (
688:
478:
403:
379:
375:
318:
255:
1640:
1580:
1540:
900:
668:). The arrhythmia can also be triggered when an external stimulus such as
52:
3038:
2936:
2726:
2643:
2625:
2451:
2424:
2375:
2316:
751:
711:. Treatments used to prevent torsades in specific circumstances include
704:
622:) - may not be present in the short-coupled variant of torsade de pointes
615:
521:
Action potential of cardiac muscles can be broken down into five phases:
500:
484:
466:
461:
395:
371:
322:
298:
259:
243:
115:
65:
2035:
1690:
879:(1966). "La tachycardie ventriculaire a deux foyers opposes variables".
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2092:
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415:
391:
355:
342:
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302:
267:
202:
82:
1773:
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263:
824:"Torsade de Pointes: Overview, Pathophysiology, Etiology of Torsade"
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2149:
794:
383:
290:
104:
399:
3072:
3052:
2207:
1612:
657:
1218:
691:, sustained torsades requires emergency treatment to prevent
177:
1932:
1930:
738:
that occur in this phase with calcium influx into the cell.
695:. The most effective treatment to terminate torsades is an
168:
1910:"Episode 12: Why does magnesium treat torsades de pointes?"
957:
664:
of the heart muscle or with prolonged repolarization time (
619:
423:
222:, translated as "twisting of peaks") is a specific type of
188:
1812:
1104:
913:
604:
may be seen in the ECG before the initiation of torsades.
1927:
1407:
Clinical
Factors Associated with Prolonged QTc and/or TdP
1105:
Mukarram, O.; Hindi, Y.; Catalasan, G.; Ward, J. (2016).
1659:"The "R-on-T" Phenomenon: An Update and Critical Review"
1510:
1430:(21st ed.). United Kingdom: Elsevier. p. 568.
1314:
1561:
1267:
1159:"Prevention of Torsade de Pointes in Hospital Settings"
1456:"Drug induced QT prolongation and torsades de pointes"
1155:
772:
an ornamental motif, as seen on architectural columns.
309:
are common contributors to torsades de pointes risk.
199:
174:
171:
2025:
1357:
746:
The phenomenon was originally described in a French
254:
Most episodes will revert spontaneously to a normal
205:
196:
185:
180:
165:
1756:Thomas, Simon H. L.; Behr, Elijah R. (March 2016).
1703:
193:
107:, certain drugs, electrolyte disorders which cause
2139:
3206:
1449:
1447:
1058:Schwartz, Peter J.; Woosley, Raymond L. (2016).
1057:
881:Archives des maladies du coeur et des vaisseaux
611:Drastic rotation of the heart's electrical axis
1428:Davidson's Principles and Practice of Medicine
652:On the ECG, this phenomenon is showing when a
234:that exhibits distinct characteristics on the
128:~5% of 300,000 sudden cardiac deaths in the US
2125:
1444:
1214:
1212:
1163:Journal of the American College of Cardiology
1064:Journal of the American College of Cardiology
426:and, in some cases, augmentation of the late
1308:
238:(ECG). It was described by French physician
1015:Indian Pacing and Electrophysiology Journal
875:
577:The ECG tracing in torsades demonstrates a
2442:Arrhythmogenic right ventricular dysplasia
2132:
2118:
1977:
1755:
1454:Yap, Yee Guan; Camm, A John (2017-01-17).
1300:: CS1 maint: location missing publisher (
1209:
446:showing a TdP patient being shocked by an
51:
2005:
1995:
1954:
1877:
1789:
1729:
1630:
1589:
1579:
1487:
1416:, CredibleMeds.org, accessed 8 June 2019.
1383:
1244:
1182:
1157:College of Cardiology Foundation (2010).
1132:
1122:
1034:
985:
975:
582:blood pressure, leading to dizziness and
418:. In one example, the gastrokinetic drug
64:(TdP) in a 56-year-old white female with
1936:
1762:British Journal of Clinical Pharmacology
1425:
887:(2). Prepared by Rahel Farhad: 263â272.
709:medications that prolong the QT interval
437:
348:
1971:
1453:
14:
3207:
2176:Spontaneous coronary artery dissection
1652:
1650:
1268:Vallerand, April Hazard (2014-06-05).
448:implantable cardioverter-defibrillator
2113:
1854:
1852:
1751:
1749:
1656:
672:falls in the vulnerable phase of the
249:
217:
2500:Nonbacterial thrombotic endocarditis
1606:
719:in long QT syndrome. Occasionally a
636:
258:. Symptoms and consequences include
1706:"The classical "R-on-T" phenomenon"
1647:
1555:
579:polymorphic ventricular tachycardia
24:
2796:Accelerated idioventricular rhythm
1849:
1746:
516:
25:
3231:
1376:10.1161/CIRCULATIONAHA.113.007765
630:premature ventricular contraction
1827:10.1111/j.1442-200X.2006.02177.x
1568:Cardiology Research and Practice
1525:10.2165/00003495-199447010-00004
337:, or particular foods including
161:
2481:Subacute bacterial endocarditis
1902:
1806:
1697:
1504:
1419:
1400:
1351:
1261:
1225:British Journal of Pharmacology
1199:
781:The singular and plural forms (
433:
325:, when taken concurrently with
1980:"Mon bĂȘte noir (my pet peeve)"
1149:
1060:"Predicting the Unpredictable"
1051:
1002:
951:
907:
869:
851:
816:
776:
274:(during longer episodes), and
13:
1:
2998:Pulseless electrical activity
2927:Multifocal atrial tachycardia
2801:Catecholaminergic polymorphic
1984:Journal of Medical Toxicology
1657:Engel, Toby R. (1978-02-01).
1270:Davis's drug guide for nurses
809:
242:in 1966. Prolongation of the
27:Type of abnormal heart rhythm
929:10.1097/CCM.0b013e318232db4a
682:
572:
496:Left ventricular hypertrophy
7:
1663:Annals of Internal Medicine
1329:10.1592/phco.20.9.776.35208
769:long hair twisted together;
270:(during shorter episodes),
10:
3236:
2942:Wandering atrial pacemaker
2489:non-infective endocarditis
2430:Endocardial fibroelastosis
1956:10.1161/01.CIR.100.13.1462
1675:10.7326/0003-4819-88-2-221
1175:10.1016/j.jacc.2010.01.001
1076:10.1016/j.jacc.2015.12.063
1027:10.1016/j.ipej.2018.07.007
741:
736:early afterdepolarizations
567:early after-depolarisation
3159:
3102:
3020:hexaxial reference system
3011:
2978:
2965:Jervell and Lange-Nielsen
2950:
2908:
2867:
2844:
2818:
2786:
2744:
2725:
2624:
2610:
2510:
2495:LibmanâSacks endocarditis
2464:
2450:
2366:
2315:
2308:
2245:
2200:
2157:
2148:
2069:
2029:
1997:10.1007/s13181-011-0153-7
1722:10.1016/j.ihj.2015.02.030
977:10.1186/s40560-018-0329-1
964:Journal of Intensive Care
725:implantable defibrillator
707:), and withdrawal of any
311:QT-prolonging medications
281:
124:
114:
100:
88:
76:
59:
50:
42:
35:
2900:Ventricular fibrillation
2171:Coronary artery aneurysm
1815:Pediatrics International
1472:10.1136/heart.89.11.1363
1111:Case Reports in Medicine
697:electrical cardioversion
654:ventricular extrasystole
647:ventricular fibrillation
588:ventricular fibrillation
219:[tÉÊsaddÉpwÉÌtÌȘ]
3177:Diastolic heart failure
3151:Athletic heart syndrome
3112:Ventricular hypertrophy
2846:Pre-excitation syndrome
2700:Left posterior fascicle
2225:Acute coronary syndrome
2165:Coronary artery disease
1879:10.1093/europace/euv319
1632:10.1161/01.CIR.89.1.206
732:calcium channel blocker
643:ventricular tachycardia
506:Subarachnoid hemorrhage
450:back to their baseline
232:ventricular tachycardia
3220:French medical phrases
2695:Left anterior fascicle
2475:infective endocarditis
2260:Hibernating myocardium
2141:Cardiovascular disease
1914:The Curious Clinicians
1237:10.1038/sj.bjp.0706070
917:Critical Care Medicine
839:Cite journal requires
756:atrioventricular block
454:
230:. It is a polymorphic
2859:WolffâParkinsonâWhite
2819:Premature contraction
2717:AdamsâStokes syndrome
2420:Loeffler endocarditis
2230:Myocardial infarction
475:(low serum magnesium)
469:(low serum potassium)
441:
349:Medications as causes
224:abnormal heart rhythm
109:increased QT interval
3026:Right axis deviation
2988:Sudden cardiac death
2346:Pericardial effusion
2289:Ventricular aneurysm
1710:Indian Heart Journal
1124:10.1155/2016/4061980
791:torsades des pointes
329:inhibitors, such as
276:sudden cardiac death
240:François Dessertenne
228:sudden cardiac death
146:torsades des pointes
3031:Left axis deviation
2888:Atrial fibrillation
2883:Ventricular flutter
2806:Torsades de pointes
2680:Bundle branch block
2639:Sick sinus syndrome
2425:Cardiac amyloidosis
2410:Tachycardia-induced
2265:Myocardial stunning
2213:Prinzmetal's angina
2182:Coronary thrombosis
2098:Torsades de pointes
1978:Mullins ME (2011).
1581:10.4061/2010/524764
865:on August 14, 2020.
787:torsades de pointes
553:Exciting triggers (
481:(low serum calcium)
299:low serum potassium
295:low serum magnesium
136:Torsades de pointes
70:low blood magnesium
66:low blood potassium
62:torsades de pointes
37:Torsades de pointes
3215:Cardiac arrhythmia
3134:Atrial enlargement
2932:Pacemaker syndrome
2854:LownâGanongâLevine
2776:Junctional ectopic
2771:AV nodal reentrant
2277:Myocardial rupture
2187:Coronary vasospasm
2070:External resources
1412:2020-08-16 at the
804:vive la difference
783:torsade de pointes
701:magnesium sulphate
455:
250:Signs and symptoms
140:torsade de pointes
18:Torsade de pointes
3202:
3201:
3194:Obstructive shock
3098:
3097:
3045:Short QT syndrome
3012:Other / ungrouped
3003:Sinoatrial arrest
2918:Ectopic pacemaker
2814:
2813:
2634:Sinus bradycardia
2606:
2605:
2602:
2601:
2351:Cardiac tamponade
2304:
2303:
2294:Dressler syndrome
2192:Myocardial bridge
2107:
2106:
1937:Moise NS (1999).
1872:(11): 1601â1687.
1774:10.1111/bcp.12726
1466:(11): 1363â1372.
1437:978-0-7020-3084-0
1279:978-0-8036-4085-6
1070:(13): 1639â1650.
637:R-on-T phenomenon
597:R-on-T phenomenon
307:drug interactions
236:electrocardiogram
226:that can lead to
132:
131:
68:(2.4 mmol/L) and
30:Medical condition
16:(Redirected from
3227:
3167:Cardiac fibrosis
3059:T wave alternans
2952:Long QT syndrome
2746:Supraventricular
2742:
2741:
2675:Intraventricular
2622:
2621:
2462:
2461:
2313:
2312:
2158:Coronary disease
2155:
2154:
2134:
2127:
2120:
2111:
2110:
2027:
2026:
2020:
2019:
2009:
1999:
1975:
1969:
1968:
1958:
1934:
1925:
1924:
1922:
1921:
1906:
1900:
1899:
1881:
1856:
1847:
1846:
1810:
1804:
1803:
1793:
1753:
1744:
1743:
1733:
1701:
1695:
1694:
1654:
1645:
1644:
1634:
1610:
1604:
1603:
1593:
1583:
1559:
1553:
1552:
1508:
1502:
1501:
1491:
1451:
1442:
1441:
1423:
1417:
1404:
1398:
1397:
1387:
1355:
1349:
1348:
1312:
1306:
1305:
1299:
1291:
1265:
1259:
1258:
1248:
1216:
1207:
1203:
1197:
1196:
1186:
1153:
1147:
1146:
1136:
1126:
1102:
1096:
1095:
1055:
1049:
1048:
1038:
1006:
1000:
999:
989:
979:
955:
949:
948:
911:
905:
904:
873:
867:
866:
861:. Archived from
855:
849:
848:
842:
837:
835:
827:
820:
800:natural language
666:long QT syndrome
599:
598:
592:long QT syndrome
487:(slow heartbeat)
360:fluoroquinolones
221:
216:
212:
211:
208:
207:
204:
201:
198:
195:
191:
190:
187:
183:
182:
179:
176:
173:
170:
167:
55:
33:
32:
21:
3235:
3234:
3230:
3229:
3228:
3226:
3225:
3224:
3205:
3204:
3203:
3198:
3189:Rheumatic fever
3155:
3094:
3007:
2974:
2946:
2904:
2863:
2840:
2810:
2782:
2729:
2721:
2615:
2598:
2506:
2455:
2446:
2362:
2356:Hemopericardium
2300:
2241:
2235:Unstable angina
2208:Angina pectoris
2201:Active ischemia
2196:
2144:
2138:
2108:
2103:
2102:
2065:
2064:
2038:
2024:
2023:
1976:
1972:
1935:
1928:
1919:
1917:
1908:
1907:
1903:
1857:
1850:
1811:
1807:
1754:
1747:
1702:
1698:
1655:
1648:
1611:
1607:
1560:
1556:
1509:
1505:
1452:
1445:
1438:
1424:
1420:
1414:Wayback Machine
1405:
1401:
1356:
1352:
1317:Pharmacotherapy
1313:
1309:
1293:
1292:
1280:
1266:
1262:
1217:
1210:
1204:
1200:
1154:
1150:
1103:
1099:
1056:
1052:
1007:
1003:
956:
952:
912:
908:
877:Dessertenne, F.
874:
870:
857:
856:
852:
840:
838:
829:
828:
822:
821:
817:
812:
779:
748:medical journal
744:
685:
639:
628:Triggered by a
596:
595:
575:
519:
517:Pathophysiology
436:
351:
327:cytochrome P450
284:
268:lightheadedness
252:
214:
192:
184:
164:
160:
60:12-lead ECG of
31:
28:
23:
22:
15:
12:
11:
5:
3233:
3223:
3222:
3217:
3200:
3199:
3197:
3196:
3191:
3186:
3185:
3184:
3182:Cardiac asthma
3179:
3169:
3163:
3161:
3157:
3156:
3154:
3153:
3148:
3147:
3146:
3141:
3131:
3130:
3129:
3124:
3119:
3108:
3106:
3100:
3099:
3096:
3095:
3093:
3092:
3090:Strain pattern
3087:
3086:
3085:
3080:
3075:
3063:
3062:
3061:
3049:
3048:
3047:
3035:
3034:
3033:
3028:
3015:
3013:
3009:
3008:
3006:
3005:
3000:
2995:
2990:
2984:
2982:
2980:Cardiac arrest
2976:
2975:
2973:
2972:
2967:
2962:
2960:AndersenâTawil
2956:
2954:
2948:
2947:
2945:
2944:
2939:
2934:
2929:
2924:
2914:
2912:
2906:
2905:
2903:
2902:
2897:
2896:
2895:
2885:
2880:
2878:Atrial flutter
2874:
2872:
2865:
2864:
2862:
2861:
2856:
2850:
2848:
2842:
2841:
2839:
2838:
2833:
2828:
2822:
2820:
2816:
2815:
2812:
2811:
2809:
2808:
2803:
2798:
2792:
2790:
2784:
2783:
2781:
2780:
2779:
2778:
2773:
2763:
2762:
2761:
2750:
2748:
2739:
2723:
2722:
2720:
2719:
2714:
2713:
2712:
2707:
2702:
2697:
2692:
2687:
2677:
2672:
2671:
2670:
2665:
2660:
2650:
2641:
2636:
2630:
2628:
2619:
2608:
2607:
2604:
2603:
2600:
2599:
2597:
2596:
2595:
2594:
2589:
2577:
2576:
2575:
2570:
2558:
2557:
2556:
2551:
2539:
2538:
2537:
2532:
2527:
2514:
2512:
2508:
2507:
2505:
2504:
2503:
2502:
2497:
2485:
2484:
2483:
2470:
2468:
2459:
2448:
2447:
2445:
2444:
2439:
2438:
2437:
2432:
2427:
2422:
2417:
2412:
2407:
2402:
2401:
2400:
2388:Cardiomyopathy
2385:
2384:
2383:
2381:Chagas disease
2372:
2370:
2364:
2363:
2361:
2360:
2359:
2358:
2353:
2343:
2342:
2341:
2332:
2321:
2319:
2310:
2306:
2305:
2302:
2301:
2299:
2298:
2297:
2296:
2291:
2281:
2280:
2279:
2269:
2268:
2267:
2262:
2251:
2249:
2243:
2242:
2240:
2239:
2238:
2237:
2232:
2222:
2221:
2220:
2215:
2204:
2202:
2198:
2197:
2195:
2194:
2189:
2184:
2179:
2173:
2168:
2161:
2159:
2152:
2146:
2145:
2137:
2136:
2129:
2122:
2114:
2105:
2104:
2101:
2100:
2089:
2074:
2073:
2071:
2067:
2066:
2063:
2062:
2051:
2039:
2034:
2033:
2031:
2030:Classification
2022:
2021:
1970:
1926:
1901:
1848:
1821:(2): 112â117.
1805:
1768:(3): 420â427.
1745:
1716:(4): 392â394.
1696:
1669:(2): 221â225.
1646:
1605:
1554:
1503:
1443:
1436:
1418:
1399:
1370:(3): 224â234.
1350:
1307:
1278:
1260:
1231:(3): 376â385.
1208:
1198:
1169:(9): 934â947.
1148:
1097:
1050:
1021:(5): 165â171.
1001:
950:
923:(2): 394â399.
906:
868:
850:
841:|journal=
814:
813:
811:
808:
778:
775:
774:
773:
770:
767:
743:
740:
693:cardiac arrest
684:
681:
638:
635:
634:
633:
626:
623:
612:
574:
571:
559:
558:
548:
541:
535:
529:
518:
515:
514:
513:
511:Hypothyroidism
508:
503:
498:
493:
488:
482:
476:
473:Hypomagnesemia
470:
464:
452:cardiac rhythm
435:
432:
428:sodium channel
388:phenothiazines
350:
347:
315:clarithromycin
283:
280:
251:
248:
153:; also called
130:
129:
126:
122:
121:
118:
112:
111:
102:
98:
97:
95:Cardiac arrest
92:
86:
85:
80:
74:
73:
57:
56:
48:
47:
44:
40:
39:
29:
26:
9:
6:
4:
3:
2:
3232:
3221:
3218:
3216:
3213:
3212:
3210:
3195:
3192:
3190:
3187:
3183:
3180:
3178:
3175:
3174:
3173:
3172:Heart failure
3170:
3168:
3165:
3164:
3162:
3158:
3152:
3149:
3145:
3142:
3140:
3137:
3136:
3135:
3132:
3128:
3125:
3123:
3120:
3118:
3115:
3114:
3113:
3110:
3109:
3107:
3105:
3101:
3091:
3088:
3084:
3083:ST depression
3081:
3079:
3076:
3074:
3071:
3070:
3069:
3068:
3064:
3060:
3057:
3056:
3055:
3054:
3050:
3046:
3043:
3042:
3041:
3040:
3036:
3032:
3029:
3027:
3024:
3023:
3022:
3021:
3017:
3016:
3014:
3010:
3004:
3001:
2999:
2996:
2994:
2991:
2989:
2986:
2985:
2983:
2981:
2977:
2971:
2968:
2966:
2963:
2961:
2958:
2957:
2955:
2953:
2949:
2943:
2940:
2938:
2935:
2933:
2930:
2928:
2925:
2923:
2919:
2916:
2915:
2913:
2911:
2907:
2901:
2898:
2894:
2891:
2890:
2889:
2886:
2884:
2881:
2879:
2876:
2875:
2873:
2871:
2866:
2860:
2857:
2855:
2852:
2851:
2849:
2847:
2843:
2837:
2834:
2832:
2829:
2827:
2824:
2823:
2821:
2817:
2807:
2804:
2802:
2799:
2797:
2794:
2793:
2791:
2789:
2785:
2777:
2774:
2772:
2769:
2768:
2767:
2764:
2760:
2757:
2756:
2755:
2752:
2751:
2749:
2747:
2743:
2740:
2737:
2733:
2728:
2724:
2718:
2715:
2711:
2710:Trifascicular
2708:
2706:
2703:
2701:
2698:
2696:
2693:
2691:
2688:
2686:
2683:
2682:
2681:
2678:
2676:
2673:
2669:
2666:
2664:
2661:
2659:
2656:
2655:
2654:
2651:
2649:
2645:
2642:
2640:
2637:
2635:
2632:
2631:
2629:
2627:
2623:
2620:
2618:
2613:
2609:
2593:
2592:regurgitation
2590:
2588:
2585:
2584:
2583:
2582:
2578:
2574:
2573:regurgitation
2571:
2569:
2566:
2565:
2564:
2563:
2559:
2555:
2554:regurgitation
2552:
2550:
2547:
2546:
2545:
2544:
2540:
2536:
2535:regurgitation
2533:
2531:
2528:
2526:
2523:
2522:
2521:
2520:
2516:
2515:
2513:
2509:
2501:
2498:
2496:
2493:
2492:
2491:
2490:
2486:
2482:
2479:
2478:
2477:
2476:
2472:
2471:
2469:
2467:
2463:
2460:
2458:
2453:
2449:
2443:
2440:
2436:
2433:
2431:
2428:
2426:
2423:
2421:
2418:
2416:
2413:
2411:
2408:
2406:
2403:
2399:
2396:
2395:
2394:
2391:
2390:
2389:
2386:
2382:
2379:
2378:
2377:
2374:
2373:
2371:
2369:
2365:
2357:
2354:
2352:
2349:
2348:
2347:
2344:
2340:
2336:
2333:
2331:
2328:
2327:
2326:
2323:
2322:
2320:
2318:
2314:
2311:
2307:
2295:
2292:
2290:
2287:
2286:
2285:
2282:
2278:
2275:
2274:
2273:
2270:
2266:
2263:
2261:
2258:
2257:
2256:
2253:
2252:
2250:
2248:
2244:
2236:
2233:
2231:
2228:
2227:
2226:
2223:
2219:
2218:Stable angina
2216:
2214:
2211:
2210:
2209:
2206:
2205:
2203:
2199:
2193:
2190:
2188:
2185:
2183:
2180:
2177:
2174:
2172:
2169:
2166:
2163:
2162:
2160:
2156:
2153:
2151:
2147:
2142:
2135:
2130:
2128:
2123:
2121:
2116:
2115:
2112:
2099:
2095:
2094:
2090:
2088:
2085:
2081:
2080:
2076:
2075:
2072:
2068:
2061:
2057:
2056:
2052:
2050:
2046:
2045:
2041:
2040:
2037:
2032:
2028:
2017:
2013:
2008:
2003:
1998:
1993:
1989:
1985:
1981:
1974:
1966:
1962:
1957:
1952:
1948:
1944:
1940:
1933:
1931:
1915:
1911:
1905:
1897:
1893:
1889:
1885:
1880:
1875:
1871:
1867:
1863:
1855:
1853:
1844:
1840:
1836:
1832:
1828:
1824:
1820:
1816:
1809:
1801:
1797:
1792:
1787:
1783:
1779:
1775:
1771:
1767:
1763:
1759:
1752:
1750:
1741:
1737:
1732:
1727:
1723:
1719:
1715:
1711:
1707:
1700:
1692:
1688:
1684:
1680:
1676:
1672:
1668:
1664:
1660:
1653:
1651:
1642:
1638:
1633:
1628:
1625:(1): 206â15.
1624:
1620:
1616:
1609:
1601:
1597:
1592:
1587:
1582:
1577:
1573:
1569:
1565:
1558:
1550:
1546:
1542:
1538:
1534:
1530:
1526:
1522:
1518:
1514:
1507:
1499:
1495:
1490:
1485:
1481:
1477:
1473:
1469:
1465:
1461:
1457:
1450:
1448:
1439:
1433:
1429:
1422:
1415:
1411:
1408:
1403:
1395:
1391:
1386:
1381:
1377:
1373:
1369:
1365:
1361:
1354:
1346:
1342:
1338:
1334:
1330:
1326:
1323:(7): 776â86.
1322:
1318:
1311:
1303:
1297:
1289:
1285:
1281:
1275:
1271:
1264:
1256:
1252:
1247:
1242:
1238:
1234:
1230:
1226:
1222:
1215:
1213:
1202:
1194:
1190:
1185:
1180:
1176:
1172:
1168:
1164:
1160:
1152:
1144:
1140:
1135:
1130:
1125:
1120:
1116:
1112:
1108:
1101:
1093:
1089:
1085:
1081:
1077:
1073:
1069:
1065:
1061:
1054:
1046:
1042:
1037:
1032:
1028:
1024:
1020:
1016:
1012:
1005:
997:
993:
988:
983:
978:
973:
969:
965:
961:
954:
946:
942:
938:
934:
930:
926:
922:
918:
910:
902:
898:
894:
890:
886:
883:(in French).
882:
878:
872:
864:
860:
854:
846:
833:
826:. 2021-04-03.
825:
819:
815:
807:
805:
801:
796:
792:
788:
784:
771:
768:
765:
761:
760:
759:
757:
753:
749:
739:
737:
733:
728:
726:
722:
718:
714:
713:beta blockers
710:
706:
702:
698:
694:
690:
680:
677:
675:
674:cardiac cycle
671:
670:cardioversion
667:
663:
659:
655:
650:
648:
644:
631:
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38:
34:
19:
3104:Cardiomegaly
3078:ST elevation
3065:
3051:
3037:
3018:
2922:Ectopic beat
2870:fibrillation
2805:
2705:Bifascicular
2579:
2560:
2541:
2517:
2487:
2473:
2466:Endocarditis
2405:Hypertrophic
2339:Constrictive
2325:Pericarditis
2283:
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2254:
2091:
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1987:
1983:
1973:
1949:(13): 1462.
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1942:
1918:. Retrieved
1916:. 2020-10-28
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863:the original
853:
832:cite journal
818:
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790:
786:
782:
780:
764:Aran sweater
745:
729:
705:hypokalaemia
689:sinus rhythm
686:
678:
651:
640:
632:(R-on-T PVC)
606:
578:
576:
564:
560:
554:
550:
543:
537:
531:
525:
520:
479:Hypocalcemia
456:
434:Risk factors
424:hERG channel
404:procainamide
380:azithromycin
376:erythromycin
352:
319:levofloxacin
288:
285:
260:palpitations
256:sinus rhythm
253:
155:
154:
150:
145:
144:
139:
135:
134:
133:
116:Risk factors
61:
36:
2970:RomanoâWard
2937:Parasystole
2836:Ventricular
2788:Ventricular
2727:Tachycardia
2644:Heart block
2626:Bradycardia
2452:Endocardium
2415:Restrictive
2376:Myocarditis
2317:Pericardium
1943:Circulation
1866:EP Europace
1619:Circulation
1364:Circulation
777:Terminology
752:Dessertenne
616:QT interval
501:Hypothermia
485:Bradycardia
467:Hypokalemia
462:Medications
396:ondansetron
392:anti-emetic
372:chloroquine
323:haloperidol
244:QT interval
72:(1.6 mg/dL)
43:Other names
3209:Categories
2868:Flutter /
2831:Junctional
2766:Junctional
2759:Multifocal
2732:paroxysmal
2648:Sinoatrial
2617:arrhythmia
2612:Conduction
2368:Myocardium
2093:Patient UK
2055:DiseasesDB
1990:(2): 181.
1920:2023-10-23
810:References
717:mexiletine
614:Prolonged
416:dofetilide
356:amiodarone
343:loperamide
339:grapefruit
335:cimetidine
331:fluoxetine
303:alcoholics
105:Hereditary
83:Cardiology
46:Torsade(s)
3127:Pulmonary
2910:Pacemaker
2581:pulmonary
2562:tricuspid
2398:Alcoholic
2087:emerg/596
2079:eMedicine
1888:1532-2092
1782:1365-2125
1683:0003-4819
1533:0012-6667
1480:1355-6037
1296:cite book
1288:881473728
893:0003-9683
721:pacemaker
683:Treatment
602:T-U waves
573:Diagnosis
420:cisapride
412:ibutilide
408:quinidine
364:methadone
264:dizziness
78:Specialty
2993:Asystole
2893:Familial
2587:stenosis
2568:stenosis
2549:stenosis
2530:stenosis
2525:prolapse
2247:Sequelae
2150:Ischemia
2084:med/2286
2016:21461788
1965:10500317
1896:26318695
1843:24904388
1835:16635167
1800:26183037
1740:26304578
1600:21253542
1498:14594906
1410:Archived
1394:24895457
1345:19897963
1337:10907968
1255:15655517
1193:20185054
1143:26989420
1092:35723658
1084:27150690
1045:30036649
996:30214811
945:27017787
937:22001585
795:headword
662:ischemia
584:fainting
551:Phase 4:
544:Phase 3:
538:Phase 2:
532:Phase 1:
526:Phase 0:
442:Lead II
384:pimozide
313:such as
291:diarrhea
272:fainting
156:torsades
2393:Dilated
2335:Chronic
2143:(heart)
2049:D016171
2007:3724434
1791:4767204
1731:4561790
1641:8281648
1591:3021856
1574:: 1â4.
1549:1153199
1541:7510621
1489:1767957
1385:4101031
1246:1576014
1184:3057430
1134:4775784
1117:: 1â3.
1036:6198685
987:6131849
901:4956181
742:History
400:sotalol
368:lithium
358:, most
215:French:
3073:J wave
2826:Atrial
2754:Atrial
2543:aortic
2519:mitral
2511:Valves
2457:valves
2309:Layers
2178:(SCAD)
2014:
2004:
1963:
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282:Causes
125:Deaths
101:Causes
3160:Other
3144:Right
3122:Right
2736:sinus
2685:Right
2435:Viral
2330:Acute
2284:weeks
2255:hours
2167:(CAD)
2060:29252
1839:S2CID
1691:75705
1545:S2CID
1513:Drugs
1460:Heart
1341:S2CID
1088:S2CID
941:S2CID
656:(R) (
321:, or
3139:Left
3117:Left
2734:and
2690:Left
2272:days
2044:MeSH
2012:PMID
1961:PMID
1892:PMID
1884:ISSN
1831:PMID
1796:PMID
1778:ISSN
1736:PMID
1687:PMID
1679:ISSN
1637:PMID
1596:PMID
1572:2010
1537:PMID
1529:ISSN
1494:PMID
1476:ISSN
1432:ISBN
1390:PMID
1333:PMID
1302:link
1284:OCLC
1274:ISBN
1251:PMID
1189:PMID
1139:PMID
1115:2016
1080:PMID
1041:PMID
992:PMID
933:PMID
897:PMID
889:ISSN
845:help
789:and
645:and
620:LQTS
555:e.g.
2002:PMC
1992:doi
1951:doi
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1770:doi
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