Torsades de pointes: Difference between revisions
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==Treatment== | ==Treatment== | ||
#Magnesium | Increasing HR decreases QT interval | ||
##1-2gm IV over 1-2 min; then 1-2gm/hr gtt | #Magnesium - decreases calcium influx | ||
#[[Overdrive Pacing]] | ##1-2gm IV over 1-2 min, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) gtt | ||
###Danger of hyperMag2+ → depressed neuromuscular function | |||
###Supplement with K+ | |||
#Isoproterenol - Increases HR / AV conduction | |||
##2-8 mcg/min | |||
#[[Overdrive Pacing]] - Atrial over ventricular pacing | |||
##Goal HR 90-120 | ##Goal HR 90-120 | ||
==See Also== | ==See Also== | ||
Revision as of 04:44, 8 January 2014
Background
- Most commonly occurs in pts w/ prolonged QT due to heart diseaes or meds:
- Procainamide
- Phenothiazine
- TCAs
- Qunidine
- Disopyramide
Treatment
Increasing HR decreases QT interval
- Magnesium - decreases calcium influx
- 1-2gm IV over 1-2 min, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) gtt
- Danger of hyperMag2+ → depressed neuromuscular function
- Supplement with K+
- 1-2gm IV over 1-2 min, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) gtt
- Isoproterenol - Increases HR / AV conduction
- 2-8 mcg/min
- Overdrive Pacing - Atrial over ventricular pacing
- Goal HR 90-120
See Also
Source
- Tintinalli