How is torsades de pointes treated

  • If the patient is unstable with ongoing VT, electrical cardioversion is warranted.
  • If an offending drug (such as procainamide) is suspected as the cause, the drug should be discontinued immediately.
  • Magnesium should generally be given even if the patient's serum levels are normal. Look for and correct other electrolyte abnormalities such as hypokalemia.
  • Acute myocardial ischemia should be considered and treated if present.
  • In certain cases isoproterenol or temporary pacing (to avoid bradycardia) may be life saving. Pacing is the treatment of choice when torsades is the consequence of a severe bradyarrhythmia such as complete heart block.

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