• malignant rhythm
• torades de points = twisting of the points = shifting axis
  • this is a specific subset of PVT
  • TDP has QT prolongation
• even if patient looks stable, attach pads and don't leave the room

• polymorphic VT
• axis twists around isoelectric line of ECG

• long QTS

• inherently unstable
  • either reverts to SR
  • or degenerates into VF

• same as for VF/VT
  • defib + CPR per ALS
• key differences
  • Mg 2-4 g IV
  • treat hypoK, aim K > 4.5
  • overdrive pacing 100-140 bpm
    • medical
      • hypotension = Ad
      • normotension
        • dobutamine
        • isoprenaline
    • electrical pacing
      • transvenous
      • transcutaneous
  • Anti-arrhythmic
    • 1st = lignocaine
      • 1 mg/kg
    • AVOID = amiodarone, BB, most other AAD
      • these slow HR / prolong QT

• Pre-op
• Intra-op
• Post-op

https://emcrit.org/ibcc/tdp/