ECG-VENTRICULAR ARRHYTHMIA (TORSADES DE POINTES)

1. Torsades De Pointes (turning or twisting of the points) is a dangerous, polymorphic, VT A/W prolonged QT-interval.

2. Characterised by paroxysms of VT of changing morphology where the QRS complexes rotate around the ECG.

3. Often terminates spontaneously but may proceed to VF.

4. In a cardiac arrest situation treat as pulseless VT/VF, however regardless of the degree of compromise, treatment should be aimed at identifying & treating the cause of the shortening QT-interval.

5. Causes: shortening of the QT-interval may be caused by over-drive pacing, isoprenaline infusion and by ceasing anti-arrhythmic drugs which prolong QT-interval.

6. Management: IV magnesium sulphate.