ECG characteristics of Torsades de Pointes (TdP)


Torsades de Pointes (TdP) was coined by Dessertnne in 1966 as a polymorphic ventricular tachycardia characterized by twisting of points.



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ECG features:

1. Change in amplitude (QRS) and twisting of the QRS complexes around the isoelectric line

2. Short-long-short pattern of R-R cycles (short-coupled PVC followed by a compensatory pause and then another PVC that falls close to the peak of the T wave).

3.Usually shows a warm-up phenomenon

4. Frequently terminates spontaneously (in contrast to VF that does not terminate without defibrillation).

TdP - (suggested) to be confined to polymorphic VT with marked QT prolongation (> 500 ms) and QT-U deformity because of distinct mechanistic and therapeutic entity.

- http://circ.ahajournals.org/cgi/content/full/121/8/1047

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