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
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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.
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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

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