A form of polymorphic ventricular tachycardia that is often associated with a prolonged QT interval.
Characterized by onset with an early complex that follows a long pause.
May be caused as a side effect of certain drugs, including most of the antiarrhythmic drugs, antibiotics such as erythromycin, psychotropic drugs such as Thorazine, or antihistamines such as Seldane.
This rhythm are often self-terminating, but can be rapidly fatal if it persists.
Treatment is prompt cardioversion if the rhythm is sustained, followed by intravenous magnesium, avoidance of agents that prolong the QT interval, and correction of myocardial ischemia, hypoxia, and electrolyte abnormalities.
Can occur with or without the presence of structural heart disease
Women with torsades de pointes may be a greater risk of sudden death than men (Makkar RR).
Prolonged QT interval can cause palpitations, syncope, near-syncope, and on occasion sudden death.
Methadone most common drug causing prolonged QT interval, with ventricular arrhythmias most frequent adverse effect.
Associated with antiretroviral use.
Drugs associated with torsades de pointes:
Amiodarone
Arsenic trioxide
Astemizole
Bepridil
Chloroquine
Chlorpromazine
Citalopram
Clarithromycin
Disopyramide
Dofetilide
Domperidone
Droperidol
Erythromycin
Flecainide
Halofantrine
Ibutilide
Levomethadyl
Mesoridazine
Methadone
Moxifloxacin
Pentamidine
Pimozide
Probucol
Procainamide
Quinidine
Sotalol
Sparfloxicin
Terfenadine
Thioridazine
Vandetanib