Which treatment is used for the disorder as represented by an ECG below ?
A. Magnesium Sulfate
B. Beta Blocker
C. Cardiac Pacer
D. All of the above
Ans:D. All of the above.
The condition/ disorder represented in an ECG is Torsades de pointes.
Torsades de pointes.
- Torsade de Pointes (TdP) is a form of polymorphic ventricular tachycardia associated with a long QT interval on the resting ECG.
- The ECG tracing in torsades demonstrates a polymorphic ventricular tachycardia 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”).
- Withdrawal of any offending drugs and correction of electrolyte .
- Acute and long-term cardiac pacing in patients with TdP presenting with heart block and symptomatic bradycardia or who have recurrent, pause-dependent TdP.
- Intravenous magnesium sulfate for patients with QT prolongation and few episodes of TdP.
- Beta blockers combined with cardiac pacing as acute therapy for patients with TdP and sinus bradycardia.