Tachyarrhythmias

Torsades de pointes

1. Defibrillation in hemodynamically unstable
2. IV Mag sulfate 1-2 grams IV over 15 minutes
3. temporary transvenous overdrive pacing (atrial / ventricular) at 100 BPM if Mg unresponsive
4. Long QT syndrome, Beta blockers reduce frequency of PVCs and shorten QT interval
5. Torsades w/ pauses / bradycardia – isoproterenol (0.05 to 0.1mccg/kg per minute in children 2mcg/minute in adults titrated to HR 100bpm can be used as temporizing measure

Do not synchronized cardiovert pt w/ torsades

defib okay