Guidelines for treating cardiac manifestations of organophosphates poisoning with special emphasis on long QT and Torsades De Pointes.
Organophosphate poisoning may precipitate complex ventricular arrhythmias, a frequently overlooked and potentially lethal aspect of this condition. Acute effects consist of electrocardiographic ST-T segment changes and AV conduction disturbances of varying degrees, while long-lasting cardiac changes include QT prolongation, polymorphic tachycardia ("Torsades de Pointes"), and sudden cardiac death. Cardiac monitoring of organophosphate intoxicated patients for relatively long periods after the poisoning and early aggressive treatment of arrhythmias may be the clue to better survival. We present here a review of the literature with a focus on late cardiac arrhythmias (mainly "Torsades de pointes"), possible mechanisms, and treatment modalities, with special emphasis on postpoisoning monitoring for development of arrhythmias.
Bar-Meir
Eran
E
CBRN Medical Branch, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel.
Schein
Ophir
O
Eisenkraft
Arik
A
Rubinshtein
Ronen
R
Grubstein
Ahuva
A
Militianu
Arie
A
Glikson
Michael
M
D000818:Animals; D006331:Heart Diseases / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000628:therapy*; D062025:Organophosphate Poisoning; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000628:therapy*