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Torsades de pointes, torsade de pointes or torsades des pointes (TdP; also called torsades) (/ t ɔːr ˌ s ɑː d d ə ˈ p w æ̃ t /, [2] French: [tɔʁsad də pwɛ̃t̪], translated as "twisting of peaks") is a specific type of abnormal heart rhythm that can lead to sudden cardiac death.
François Dessertenne (1917–2006) was a French physician who first described the special type of ventricular tachycardia in 1966 known as Torsades de pointes. In 1948, Dessertenne became the Assistant Professor of Medicine at Hôpital Lariboisière in France, assisting to Prof Yves Bouvrain (1910-2002).
The term "torsades de pointes" is translated from French as "twisting of the peaks" because the complexes appear to undulate, or twist around, the EKG baseline. TdP can be acquired by inheritance of a congenital long QT syndrome , or more commonly from the ingestion of a pharmacologic drug.
Torsades de pointes: 2 points T-wave alternans: 1 point Notched T-waves in at least 3 leads 1 point Low heart rate for age (children) 0.5 points Syncope with stress 2 points Cannot receive points both for syncope and Torsades without stress 1 point Congenital deafness 0.5 points Family history Other family member with confirmed LQTS 1 point
Early afterdepolarizations can result in torsades de pointes, tachycardia, and other arrhythmias. [3] EADs can be triggered by hypokalemia and drugs that prolong the QT interval, including class Ia and III antiarrhythmic agents, as well as catecholamines. [1] Afterhyperpolarizations can also occur in cortical pyramidal neurons.
Prolonged QTc is also associated with ECG findings called Torsades de Pointes, which are known to degenerate into ventricular fibrillation, associated with higher mortality rates. There are many causes of prolonged QT intervals, acquired causes being more common than genetic.
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Pimozide overdose presents with severe extrapyramidal symptoms, hypotension, sedation, QT interval prolongation and ventricular arrhythmias including torsades de pointes. [7] Gastric lavage, establishment of a patent airway and, if necessary, mechanically assisted respiration is the recommended treatment for pimozide overdose. [7]