Smith W M, Gallagher J J
Ann Intern Med. 1980 Oct;93(4):578-84. doi: 10.7326/0003-4819-93-4-578.
Since the original description by Dessertenne, predominantly European literature has reported the features of the unusual ventricular arrhythmia "les torsades de pointes." Named because of the way the polarity of the QRS complexes seems to spiral around the baseline of the ECG, this arrhythmia is virtually always associated with prolongation of the Q-T interval. Its importance lies not in its unusual structure but in the potentially fatal outcome if conventional treatment is administered. Antiarrhythmic drugs that further prolong the Q-T interval frequently aggravate the arrhythmia and are contraindicated. Overdrive pacing, preferably atrial, is the treatment of choice with attention to any correctable causes of associated Q-T prolongation. Electrophysiologic studies so far favor a re-entrant cause for the arrhythmia, but the exact mechanism and its true relation to both conventional ventricular tachycardia and ventricular fibrillation remain to be defined.
自 Dessertenne 首次描述以来，主要是欧洲的文献报道了异常室性心律失常“尖端扭转型室速”的特征。因其 QRS 波群的极性似乎围绕心电图基线螺旋式变化而得名，这种心律失常几乎总是与 Q-T 间期延长有关。其重要性不在于其异常的结构，而在于如果采用传统治疗可能导致致命后果。进一步延长 Q-T 间期的抗心律失常药物常常会加重心律失常，因此禁用。超速起搏，最好是心房超速起搏，是首选的治疗方法，同时要注意任何可纠正的导致 Q-T 间期延长的原因。迄今为止，电生理研究倾向于心律失常由折返引起，但确切机制及其与传统室性心动过速和心室颤动的真正关系仍有待明确。
