Document Detail

Preventing torsades de pointes by careful cardiac monitoring in hospital settings.
MedLine Citation:
PMID:  18019519     Owner:  NLM     Status:  MEDLINE    
In the electrocardiogram, the QT interval represents the time it takes the ventricular myocardium to repolarize. Prolongation of the QT interval indicates congenital or acquired abnormality of cardiac membrane channels. In the critical care setting, acquired long QT interval most commonly results from administration of common pharmacologic agents, including some antiarrhythmics and antibiotics. Patients with prolonged QT interval may be at risk for developing torsades de pointes and cardiac arrest. Furthermore, new-onset bradyarrhythmias and electrolyte disorders may increase this risk. Warning signs of impending sustained torsades de pointes include occurrence of polymorphic ventricular ectopic complexes, T-wave alternans, and nonsustained polymorphic ventricular tachycardia. Measurement and documentation of the QT interval, corrected for heart rate (QTc), is an important component of cardiac monitoring in the critical care setting. When prolonged QTc occurs in patients at risk, specific clinical interventions must be implemented to prevent the occurrence of torsades de pointes.
Claire E Sommargren; Barbara J Drew
Related Documents :
8198939 - Failure to reproduce the in vitro cardiac electrophysiological effects of naloxone in h...
15376499 - Characterization of qt interval adaptation to rr interval changes and its use as a risk...
20823649 - Aborted cardiac arrest in a patient carrying kcne1 d85n variant during the postpartum p...
6616779 - Bradycardia-dependent triggered activity: relevance to drug-induced multiform ventricul...
10235129 - Qt interval dispersion and autonomic modulation in subjects with anxiety.
16580419 - Effects of coronary revascularization and concomitant aneurysmectomy on qt interval dur...
9193209 - Cerebral hemispheric lateralization in cardiac autonomic control.
8198939 - Failure to reproduce the in vitro cardiac electrophysiological effects of naloxone in h...
22505199 - Synchrony relationships between the left ventricle and a left ventricular assist device...
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  AACN advanced critical care     Volume:  18     ISSN:  1559-7768     ISO Abbreviation:  -     Publication Date:    2007 Jul-Sep
Date Detail:
Created Date:  2007-11-16     Completed Date:  2007-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101269322     Medline TA:  AACN Adv Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  285-93     Citation Subset:  N    
School of Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA 94143, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Critical Care / methods*
Electrocardiography / methods*,  nursing
Heart Rate
Long QT Syndrome / complications*
Monitoring, Physiologic / methods*,  nursing
Nurse's Role
Nursing Assessment
Nursing Records
Patient Selection
Practice Guidelines as Topic
Risk Factors
Tachycardia, Supraventricular / complications,  diagnosis
Tachycardia, Ventricular / complications,  diagnosis
Torsades de Pointes* / diagnosis,  etiology,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  ST-segment monitoring: putting standards into practice.
Next Document:  ECG monitoring after cardiac surgery: postoperative atrial fibrillation and the atrial electrogram.