Author:
Keren A,Tzivoni D,Gavish D,Levi J,Gottlieb S,Benhorin J,Stern S
Abstract
Torsade de pointes, also called atypical ventricular tachycardia (AVT), was diagnosed in 10 patients, nine on antiarrhythmic therapy and one with acute central nervous system damage. Four patients received quinidine and five disopyramide, either alone or in combination with amiodarone. AVT was dose-dependent in some, but in others, it started shortly after initiation of drug therapy (idiosyncrasy). All patients had QT prolongation longer than 0.60 second immediately before the onset of AVT. This measurement appeared to be a more sensitive predictor of the development of AVT than QTc prolongation or QRS widening. All patients also showed bradycardia before AVT onset. After therapy, the QT immediately decreased, while QTc and QRS remained prolonged for longer periods. Isoproterenol was effective in five of seven patients, but was contraindicated in two others. Ventricular pacing was used in four patients, including the two who did not respond to isoproterenol, and this abolished AVT promptly. Isoproterenol or pacing appear to be the therapy of choice for AVT, while the conventional drugs used to treat the usual form of ventricular tachycardia are not only ineffective, but even contraindicated.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference40 articles.
1. Quinidine Syncope
2. La tachycardie ventriculaire a deux foyers opposes variables;Dessertenne F;Arch Mal Coeur,1966
3. Le complexe electrique ventriculaire A phase lente prolongee;Dessertenne F;Semin Hop Paris,1967
4. Tachycardie ventriculaire a foyer variable et dyskaliemie;Raynaud R;Arch Mal Coeur,1969
5. Motte G Coumel PH Abitbol G Dessertenne F Slama-R: La syndrome QT long et syncopes par "torsade de pointes." Arch Mal Coeur 63: 831 1970
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