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Tachycardia: Difference between revisions
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==Torsades de Pointes== | ==Torsades de Pointes== | ||
[[Image:VentDrg.jpg|thumb|right| | [[Image:VentDrg.jpg|thumb|right|350px]] | ||
Torsades de pointes (TdP) is a ventricular tachycardia associated with a prolonged QTc interval on the resting ECG. It is on the ECG characterized by twisting of the peaks of the QRS complexes around the isoelectric line during the arrhythmia (changing axis). Torsade de pointes is typically initiated by a short-long-short interval. A ventricle extrasystole (first beat: short) is followed by a compensatory pause. The following beat (second beat: long) has a longer QT interval. If the next beat follows shortly thereafter, there is a good chance that this third beat falls within the QT interval, resulting in the R on T phenomenon and subsequent Torsades de pointes. | Torsades de pointes (TdP) is a ventricular tachycardia associated with a prolonged QTc interval on the resting ECG. It is on the ECG characterized by twisting of the peaks of the QRS complexes around the isoelectric line during the arrhythmia (changing axis). Torsade de pointes is typically initiated by a short-long-short interval. A ventricle extrasystole (first beat: short) is followed by a compensatory pause. The following beat (second beat: long) has a longer QT interval. If the next beat follows shortly thereafter, there is a good chance that this third beat falls within the QT interval, resulting in the R on T phenomenon and subsequent Torsades de pointes. | ||
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*Intravenous magnesium sulfate for patients with QT prolongation and few episodes of 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. | *Beta blockers combined with cardiac pacing as acute therapy for patients with TdP and sinus bradycardia. | ||
*Isoproterenol as temporary treatment in patients with recurrent pause-dependent TdP who do not have congenital long QT syndrome. | *Isoproterenol as temporary treatment in patients with recurrent pause-dependent TdP who do not have congenital long QT syndrome. | ||
==Differentiation between SVT and VT== | ==Differentiation between SVT and VT== | ||
To differentiate between supraventricular tachycardias and ventricular tachycardias a 12 lead ECG is the cornerstone of the diagnostic process. At first, the physician has to make a differentiation between a small or broad complex tachycardia. | To differentiate between supraventricular tachycardias and ventricular tachycardias a 12 lead ECG is the cornerstone of the diagnostic process. At first, the physician has to make a differentiation between a small or broad complex tachycardia. | ||