Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia

You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.

WikiDoc Resources for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Articles
Most recent articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Most cited articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Review articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Images of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Photos of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Podcasts & MP3s on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Videos on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Evidence Based Medicine
Cochrane Collaboration on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Bandolier on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia TRIP on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Clinical Trials
Ongoing Trials on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia at Clinical Trials.gov Trial results on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Clinical Trials on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia NICE Guidance on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia NHS PRODIGY Guidance FDA on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia CDC on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Books
Books on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
News
Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in the news Be alerted to news on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia News trends on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Commentary
Blogs on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Definitions
Definitions of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Patient Resources / Community
Patient resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Discussion groups on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Patient Handouts on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Directions to Hospitals Treating Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Risk calculators and risk factors for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Healthcare Provider Resources
Symptoms of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Causes & Risk Factors for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Diagnostic studies for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia Treatment of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Continuing Medical Education (CME)
CME Programs on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
International
Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia en Espanol Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia en Francais
Businness
Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in the Marketplace Patents on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Experimental / Informatics
List of terms related to Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia

Cardiology Network
Discuss Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia further in the WikiDoc Cardiology Network
Adult Congenital
Biomarkers
Cardiac Rehabilitation
Congestive Heart Failure
CT Angiography
Echocardiography
Electrophysiology
Cardiology General
Genetics
Health Economics
Hypertension
Interventional Cardiology
MRI
Nuclear Cardiology
Peripheral Arterial Disease
Prevention
Public Policy
Pulmonary Embolism
Stable Angina
Valvular Heart Disease
Vascular Medicine

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Phone:617-525-7431

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Ventricular Tachycardia

• Ventricular tachycardia originates from a ventricular focus
• Lasts more than 30 seconds
• Broad QRS complexes: rate of >90 beats/minute

Paroxysmal Ventricular Tachycardia

1. Rapid succession of three or more ectopic beats.
2. Sustained if it lasts longer than 30 seconds.
3. Called incessant if the tachycardia is recurrent and the episodes are interrupted by only a few sinus beats.

EKG Findings

1. Abnormal and wide QRS complexes with secondary ST segment and T wave changes.
   
   • Usual QRS duration is > 0.12 seconds, may be shorter if the ectopic focus is located in the ventricular septum.
   • The secondary ST segment and T wave changes are in a direction that is opposite the major deflection of the QRS.
   • A ventricular rate between 140 and 200 BPM.
   • When the rate is >200 and has a sine wave appearance, it is called ventricular flutter.
   • When the rate is <110 BPM it is called non-paroxysmal VT.
2. A regular or slightly irregular (up to 0.03 seconds) rhythm.
   
3. Abrupt onset and termination.
   
4. AV dissociation.
   
   • Atrial rate slower than ventricular rate.
   • No relationship between atrial activity and ventricular activity.
   • There can be VA conduction.

     1. The RP interval is >0.11 seconds.
     2. Occurs in about 50% of cases.
     3. Uncommon when the ventricular rate is rapid (only 1/7 when the rate was>200).

5. Capture beats.
   
   • Occurs when a supraventricular impulse is conducted and captures the ventricle.
   • They are rare.
6. Fusion beats.
   
   • Rare in VT at a rapid rate.^{[1] [1] [1]}

Torsade De Pointes and Polymorphic VT

Background

1. The peaks of the QRS complexes appear to twist around the isoelectric axis.
2. Polymorphic VT is distinguished from Torsades by the absence of QT prolongation in polymorphic VT.

EKG Findings

1. Paroxysms of VT with irregular RR intervals.
2. A ventricular rate between 200 and 250 beats per minute.
3. Two or more cycles of QRS complexes with alternating polarity.
4. Changing amplitude of the QRS complexes in each cycle in a sinusoidal fashion.
5. Prolongation of the QT interval.
6. Is often initiated by a PVC with a long coupling interval, R on T phenomenon.
7. There are usually 5 to 20 complexes in each cycle.

Clinical Correlation

1. Drugs: quinidine, PCA, norpace, amiodarone, phenothiazines, Tricyclic antidepressants, pentamidine.
   • with quinidine majority of the cases occur within one week of initiation, and with therapeutic levels
2. Electrolyte imbalances: Hypokalemia, hypomagnesemia, hypocalcemia
3. CAD
4. MVP
5. Variant angina
6. Myocarditis
7. Subarachnoid hemorrhage
8. Congenital QT prolongation
9. Liquid protein diets
10. Hypothyroidism
    • because of bradycardia and a prolonged QT syndrome
11. Organophosphate poisoning ^{[1] [1]}

References

v • d • e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker

v • d • e WikiDoc Research Resources for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Most recent articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Most cited articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Review articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Articles on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Powerpoint slides on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Images of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Photos of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Podcasts & MP3s on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Videos on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Evidence Based Medicine Regarding Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Cochrane Collaboration on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Bandolier on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • TRIP on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Cost Effectiveness of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Cost Effectiveness of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Clinical Trials Involving Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Ongoing Trials on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia at Clinical Trials.gov • Trial results on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Clinical Trials on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	US National Guidelines Clearinghouse on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • NICE Guidance on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • NHS PRODIGY Guidance • FDA on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • CDC on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Textbook Information on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Books and Textbook Information on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Pharmacology Resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Dosing of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Drug interactions with Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Side effects of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Allergic reactions to Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Overdose information on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Carcinogenicity information on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in pregnancy • Pharmacokinetics of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia •
Genetics, Pharmacogenomics, and Proteinomics of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Genetics of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Pharmacogenomics of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Proteomics of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Newstories on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in the news • Be alerted to news on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • News trends on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Commentary on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Blogs on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Patient Resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Patient resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Discussion groups on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Patient Handouts on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Directions to Hospitals Treating Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Risk calculators and risk factors for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Healthcare Provider Resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Symptoms of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Causes & Risk Factors for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Diagnostic studies for Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia • Treatment of Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Continuing Medical Education (CME) Programs on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	CME Programs on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
International Resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia en Espanol • Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia en Francais
Business Resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia in the Marketplace • Patents on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia
Informatics Resources on Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia	List of terms related to Ventricular tachycardia including torsades de pointes and polymorphic ventricular tachycardia

WikiDoc Help Menu Quick Start.. Get Started Here! How to Login How to Search Pages How to Start a New Page How to Edit a Page Cheat Sheet Editing basics Learning Basic Formatting How to make Links in WikiDoc & to External Sites How to Make Lists How to Ignoring Formatting Adding References or Footnotes to Articles Tracking Changes You Have Made How to Put an Article Into a Category When Multiple Topics Should Go To The Same Page (MI, Acute MI, AMI) Using Redirection Advanced editing How to Make Tables How to Insert Images and Other Media How to Add Video Help:How to Make Columns Web Colors How To Make Templates How to Move Pages Inserting Dynamic Dates and Times Inserting WikiDoc Statistics Editing the Table of Contents Communicating your edits Let others know what you changed: The importance of Edit Summaries Minor Edits Edit Conflicts Help Videos You Can Watch Getting Started Video