The emergency department management of torsades de pointes

Abstract

This case report describes the features of polymorphic ventricular tachycardia known as torsades de pointes. The arrhythmia was probably triggered as a result of the patient taking a small dose of sotalol, in conjunction with other risk factors. The treatment of torsades de pointes is discussed, including the role of transcutaneous cardiac pacing in the emergency management of this arrhythmia.

The acute effects of magnesium in atrial fibrillation and flutter with a rapid ventricular rate

“…It also facilitates the maintenance of a low intracellular concentration of calcium, high intracellular levels of calcium being associated with the development of after‐potentials and triggered arrhythmias 18,24,31 . In vitro, magnesium infusions are known to slow the intrinsic rate of the canine sinus node and have been shown to slow intra‐atrial, AV nodal and intraventricular conduction in humans 26,27,31 . It is thus not surprising that attention has recently focused on the use of magnesium as an antiarrhythmic agent.…”

“…Magnesium is now recommended for various arrhythmias including torsades de pointes and resistant ventricular fibrillation 28–31 . It has also been used for many years for a variety of non‐cardiac conditions, notably pre‐eclampsia 33,34 .…”