[Classification and treatment of torsades de pointes (TdP): a report of 11 cases].
A clinical analysis of 11 cases with TdP was reported. These patients were divided into two groups: 9 cases with long QT syndrome and 2 with normal QT interval. All of the patients suffered from coronary heart disease with various concomitant ailments, such as pulmonary heart disease (1 case), atrioventricular block (5 cases with complete or type II second degree AV block), hypokalemia (7 cases). In one case the TdP was caused by aminodarone administration. The principle of treatment included removing the inducing causes, treating the primary diseases and interrupting TdP. All patients who had hypokalemia were treated with potassium chloride. 7 of 9 cases showed effective response to treatment with magnesium sulfate. The patients with long QT syndrome failed to respond with MgSO4. Severe bradycardia should be treated with isoprenaline. Only one patient had pacing therapy and another received electric conversion. According to our experience, for patients of TdP with long QT syndrome class Ia and III antiarrhythmic agents were contraindicated, but those with normal QT interval can take these drugs.
Mei
K Z
KZ
Department of Medicine, Red Cross Hospital, Guangzhou.
Sun
A H
AH
Li
B J
BJ
D000368:Aged; D005260:Female; D006327:Heart Block / Q000150:complications; D006801:Humans; D007008:Hypokalemia / Q000150:complications; D007545:Isoproterenol / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000188:drug therapy; D008278:Magnesium Sulfate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011189:Potassium Chloride / Q000627:therapeutic use; D016171:Torsades de Pointes / Q000145:classification* / Q000188:drug therapy* / Q000209:etiology
D011189:Potassium Chloride; D008278:Magnesium Sulfate; D007545:Isoproterenol