Paoloni P, Ciliberti D, Blasi N, Capone P
Servizio di Cardiologia, Ospedale Civile di Fermo Ascoli Piceno.
Minerva Cardioangiol. 1992 Jun;40(6):245-9.
Torsade de pointes is a form of polymorphous ventricular tachycardia in which the polarity of the QRS complex exhibits phasic alterations in both axis. Traditionally, torsade de pointes has been described in association with a congenital or acquired (including drug and metabolic) causes of QT prolongation. Clinical outcomes range from asymptomatic, self-terminating arrhythmias to ventricular fibrillation resulting in cardiac arrest. For the treatment of torsade de pointes, the conventional antiarrhythmic drugs cannot be relied on, cardiac pacing should be instituted as soon as possible; however, as this technique may not always be immediately available, isoproterenol infusion may be the first-choice treatment. Potassium and magnesium repletion appear to be essential in abolishing drug-induced torsade de pointes. This report describes a case of thioridazine-induced torsade de pointes treated efficaciously with magnesium sulphate and overdrive right ventricular pacing.
尖端扭转型室速是多形性室性心动过速的一种形式，其中QRS波群的极性在电轴上均呈现阶段性改变。传统上，尖端扭转型室速被描述为与先天性或后天性（包括药物和代谢性）QT间期延长的病因相关。临床结局范围从无症状的、可自行终止的心律失常到导致心脏骤停的心室颤动。对于尖端扭转型室速的治疗，不能依赖传统的抗心律失常药物，应尽快实施心脏起搏；然而，由于该技术可能并非总是立即可用，静脉输注异丙肾上腺素可能是首选治疗方法。补充钾和镁似乎对于消除药物诱发的尖端扭转型室速至关重要。本报告描述了一例硫利达嗪诱发的尖端扭转型室速病例，该病例经硫酸镁和超速右心室起搏治疗有效。
