Life-Threatening Ventricular Arrhythmia (Torsades de Pointes) after Haloperidol Overdose

1991 ◽  
Vol 10 (1) ◽  
pp. 59-62 ◽  
Author(s):  
R.A. Henderson ◽  
S. Lane ◽  
J.A. Henry
Keyword(s):  
Ventricular Tachycardia ◽  
Literature Review ◽  
Ventricular Arrhythmia ◽  
Torsades De Pointes ◽  
Qt Prolongation ◽  
Life Threatening ◽  
Overdrive Pacing

A 48-year-old woman developed QT prolongation and episodes of life-threatening ventricular tachycardia (torsades de pointes) after intentional overdose of haloperidol and orphenadrine. The arrhythmia did not respond to conventional anti-arrhythmic therapy but was suppressed by atrial overdrive pacing. A literature review identified haloperidol as the most likely cause of the torsades de pointes.

Left Stellate Ganglion Block for Refractory Ventricular Tachycardia: A Case Series

2021 ◽  
Vol 104 (3) ◽  
pp. 506-511
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Stellate Ganglion ◽  
Case Series ◽  
Stellate Ganglion Block ◽  
Definitive Treatment ◽  
Ganglion Block ◽  
Cardiac Implantable Electronic Devices ◽  
Left Stellate Ganglion ◽  
Life Threatening

Ventricular arrhythmias are usually well controlled with medical management, cardiac implantable electronic devices, or catheter ablation. However, the refractory ventricular tachycardia or fibrillation (VT/VF) is life threatening and challenging. The authors reported a case series of left stellate ganglion blocks (LSGB) in patients with refractory VT/VF, who failed pharmacological treatment and multiple traditional cardiac interventions. Five patients underwent six LSGB. Four patients had significant decreased in ventricular arrhythmia burden. Among the responders, the LSGB suppressed significant VT/VF for three to seven days. Blocks did not only temporary suppress ventricular arrhythmia, but also stabilized the condition and served as a bridge to definitive treatment such as EP ablation or heart transplantation. There was no significant hemodynamic change or devastating side effects. The outcome from the present case series suggested that LSGB could be an effective treatment and a lifesaving intervention frintractable VT/VF. Keywords: Stellate ganglion block, Refractory ventricular tachycardia, Sympathectomy

scholarly journals Managing drug-induced QT prolongation in clinical practice

2020 ◽  
pp. postgradmedj-2020-138661
Author(s):  
Rani Khatib ◽  
Fatima R N Sabir ◽  
Caroline Omari ◽  
Chris Pepper ◽  
Muzahir Hassan Tayebjee
Keyword(s):  
Qt Interval ◽  
Simple Algorithm ◽  
Torsades De Pointes ◽  
Daily Practice ◽  
Qt Prolongation ◽  
Key Factors ◽  
Drug Induced ◽  
Electrolyte Disturbances ◽  
Related Risk ◽  
Life Threatening

Many drug therapies are associated with prolongation of the QT interval. This may increase the risk of Torsades de Pointes (TdP), a potentially life-threatening cardiac arrhythmia. As the QT interval varies with a change in heart rate, various formulae can adjust for this, producing a ‘corrected QT’ (QTc) value. Normal QTc intervals are typically <450 ms for men and <460 ms for women. For every 10 ms increase, there is a ~5% increase in the risk of arrhythmic events. When prescribing drugs associated with QT prolongation, three key factors should be considered: patient-related risk factors (eg, female sex, age >65 years, uncorrected electrolyte disturbances); the potential risk and degree of QT prolongation associated with the proposed drug; and co-prescribed medicines that could increase the risk of QT prolongation. To support clinicians, who are likely to prescribe such medicines in their daily practice, we developed a simple algorithm to help guide clinical management in patients who are at risk of QT prolongation/TdP, those exposed to QT-prolonging medication or have QT prolongation.

scholarly journals The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Seong Huan Choi ◽  
Oh-Hyun Lee ◽  
Gwang-Seok Yoon ◽  
Sung Woo Kwon ◽  
Sung-Hee Shin ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Takotsubo Cardiomyopathy ◽  
Qt Interval ◽  
Independent Predictor ◽  
Cardiac Events ◽  
Idiopathic Ventricular Fibrillation ◽  
Life Threatening ◽  
The Relationship ◽  
J Wave

Abstract Background and objectives Takotsubo cardiomyopathy (TTC) occasionally causes life-threatening ventricular arrhythmia. J wave on surface electrocardiography (sECG) has also been associated with idiopathic ventricular fibrillation and cardiac events; therefore, we investigated whether the presence of J wave on sECG is a potential risk factor for ventricular arrhythmia in patients with TTC. Subjects and methods We performed a retrospective study in 79 patients who were diagnosed with TTC from 2010 to 2014. Among them, 20 (25.3%) were diagnosed with ventricular tachycardia (VT). The J wave on the sECG was defined as J point elevation manifested through QRS notching or slurring at least 1 mm above the baseline in at least two leads. Results A higher prevalence of ventricular tachycardia was observed in patients with J wave. The corrected QT interval (QTc) was significantly longer in the VT group than in the non-VT group. In a multivariate analysis, the presence of J wave appeared to be the only independent predictors of VT [Hazard Ratio (HR) 3.5, p = 0.019]. Conclusion Our results suggest that the presence of J wave on the sECG is significantly associated with VT, and appear to indicate that the presence of J wave is a strong and independent predictor of VT in patients with TTC.

scholarly journals QT Prolongation and Life Threatening Ventricular Tachycardia in a Patient Injected With Intravenous Meperidine (Demerol®)

2011 ◽  
Vol 41 (6) ◽  
pp. 342 ◽  
Author(s):  
Mi Kyoung Song ◽  
Eun Jung Bae ◽  
Jae Suk Baek ◽  
Bo Sang Kwon ◽  
Gi Beom Kim ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Qt Prolongation ◽  
Life Threatening

scholarly journals Resistant Ventricular Arrhythmia and the Role of Overdrive Pacing in the Suppression of the Electrical Storm

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Mohamed Magdi ◽  
Mahmood Mubasher ◽  
Hakam Alzaeem ◽  
Tahir Hamid
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Coronary Intervention ◽  
Electrical Storm ◽  
Electrical Instability ◽  
Percutaneous Coronary ◽  
Life Threatening ◽  
Overdrive Pacing ◽  
Antiarrhythmic Medications

Ventricular arrhythmia storm is a state of cardiac instability characterized by multiple ventricular arrhythmias or multiple ICD therapies within a 24-hour duration. Management of this life-threatening state depends on the reversal of the cause besides either electrical or medical management of the arrhythmia. We report a case of a 54-year-old male who underwent a percutaneous coronary intervention following massive acute myocardial infarction. Afterwards, he developed frequent life-threatening ventricular arrhythmias that required multiple shocks and antiarrhythmic medications. Despite all these interventions, it was very difficult to control the electrical instability, but after overdrive ventricular pacing, the storm subsided and within a few days the case was stabilized. Overdrive pacing is an easy temporary modality to control the resistant arrhythmia following myocardial infarction.

scholarly journals A case of hypoglycemiainduced QT prolongation leading to torsade de pointes and a review of pathophysiological mechanisms

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Faris Hannoodi ◽  
Hashim Alwash ◽  
Kushal Shah ◽  
Israa Ali ◽  
Sarwan Kumar ◽  
...  
Keyword(s):  
Torsade De Pointes ◽  
Torsades De Pointes ◽  
Serum Glucose ◽  
Interesting Case ◽  
Qt Prolongation ◽  
Calcium Oscillations ◽  
Calcium Overload ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Life Threatening

<em>Torsades de pointes</em> is a life-threatening cardiac arrhythmia. Occurrence of this arrhythmia as a result of hypoglycemia has not been reported in the literature. We describe an interesting case of an insulindependent diabetic patient presenting with torsades de pointes resulting from hypoglycemia. A 62-year-old male was admitted to the hospital following an episode of severe insulin-induced hypoglycemia and a cardiac arrest. He was found to unresponsive at home after taking insulin. His serum glucose was found to be 18. He was given juice initially to normalize his glucose and was then transferred by EMS to ER where he was given 5% dextrose infusion. Analysis of the LifeVest rhythm recording showed torsades de pointes that was terminated by defibrillation of the LifeVest. Several mechanisms are responsible for torsade, including QT interval prolongation, adrenalin secretion and calcium overload leading to intracellular calcium oscillations. These mechanisms are a trigger to torsade de pointes. Predisposing factors were present leading torsade to occur.

scholarly journals Fluconazole-associated QT interval prolongation and Torsades de Pointes in a paediatric patient

2021 ◽  
pp. 1-3
Author(s):  
Ayşe Ünal Yüksekgönül ◽  
İlker Ertuğrul ◽  
Tevfik Karagöz
Keyword(s):  
Qt Interval ◽  
Torsades De Pointes ◽  
Qt Prolongation ◽  
Polymorphic Ventricular Tachycardia ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Life Threatening ◽  
Prolonged Qt Interval ◽  
Rhythm Disorder ◽  
Anti Fungal

Abstract “Torsades de pointes”, a life-threatening rhythm disorder, is a polymorphic ventricular tachycardia that usually develops in association with a prolonged QT interval. Fluconazole, an anti-fungal drug, may also induce QT prolongation, in some cases subsequent torsades de pointes. Herein, we report a 16-year-old female presenting “torsades de pointes” after administration of fluconazole and rapidly improved upon cessation of the drug.

Sign in / Sign up

Export Citation Format

Share Document