Haverkamp W, Hördt M, Chen X, Hindricks G, Willems S, Kottkamp H, Rotman B, Brunn J, Borggrefe M, Breithardt G
Medizinische Klinik und Poliklinik, Westfälische Wilhelms-Universität Münster.
Z Kardiol. 1993 Dec;82(12):763-74.
Torsade de pointes (TDP) is a polymorphic ventricular tachycardia with a particular electrocardiographic pattern of continuously changing ("twisting") morphology of the QRS complex occurring in the setting of delayed myocardial repolarization (i.e., prolongation of the QT interval). TDP may develop in the setting of an idiopathic disorder (Jervell/Lange-Nielsen syndrome, Romano-Ward syndrome, sporadic long QT syndrome) or may be induced by pharmacologic agents which prolong the QT interval, as well as by other clinical circumstances under which repolarization is delayed (e.g., hypokalemia, hypomagnesemia, bradycardia) (acquired long QT syndrome). Since the treatment of TDP strongly differs from that of conventional ventricular tachycardia, correct diagnosis is critical as it guides the treating physician in selecting the appropriate mode of therapy. In this paper mainly the electrocardiographic criteria presently used for the correct identification of this unusual form of ventricular arrhythmia are presented. Additionally, the potential mechanisms and therapeutic modalities of TDP are discussed.
尖端扭转型室性心动过速（TDP）是一种多形性室性心动过速，在心肌复极延迟（即QT间期延长）的情况下，QRS波群形态持续变化（“扭转”），具有特定的心电图模式。TDP可发生于特发性疾病（杰韦尔/朗格-尼尔森综合征、罗曼诺-沃德综合征、散发性长QT综合征），也可由延长QT间期的药物诱发，以及在其他导致复极延迟的临床情况下（如低钾血症、低镁血症、心动过缓）（获得性长QT综合征）发生。由于TDP的治疗与传统室性心动过速有很大不同，正确诊断至关重要，因为它指导治疗医生选择合适的治疗方式。本文主要介绍目前用于正确识别这种不寻常室性心律失常形式的心电图标准。此外，还讨论了TDP的潜在机制和治疗方式。
