Polymorphic ventricular tachycardia: Difference between revisions
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==Overview== | ==Overview== | ||
Polymorphic ventricular tachcardia is a form of [[ventricular tachycardia]] in which there are multiple focci for the origin of the ventricular complex. The most common form of polymorphic VT is [[Torsade de pointes]]. | Polymorphic ventricular tachcardia is a form of [[ventricular tachycardia]] in which there are multiple focci for the origin of the ventricular complex. The most common form of polymorphic VT is [[Torsade de pointes]]. | ||
== ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref> == | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Direct current [[cardioversion]] with appropriate sedation as necessary is recommended for patients with sustained polymorphic VT with [[hemodynamic compromise]] and is reasonable at any point in the treatment cascade. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''. <nowiki>"</nowiki> | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Intravenous [[beta blockers]] are useful for patients with recurrent polymorphic VT especially if [[ischemia]] is suspected or cannot be excluded. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''. <nowiki>"</nowiki> | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Intravenous loading with [[amiodarone]] is useful for patients with recurrent polymorphic VT in the absence of abnormal repolarization related to congenital or acquired [[LQTS]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''. <nowiki>"</nowiki> | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Urgent [[angiography]] with a view to [[revascularization]] should be considered for patients with polymorphic VT when [[myocardial ischemia]] cannot be excluded. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''. <nowiki>"</nowiki> | |||
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|- | |||
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIb]] | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Intravenous [[lidocaine]] may be reasonable for treatment of polymorphic VT specifically associated with [[acute myocardial ischemia]] or [[acute myocardial infarction|infarction]]. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | |||
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==References== | ==References== | ||
Latest revision as of 20:12, 26 October 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: polymorphic VT
Related chapters: Ventricular tachycardia, Torsade de pointes
Overview
Polymorphic ventricular tachcardia is a form of ventricular tachycardia in which there are multiple focci for the origin of the ventricular complex. The most common form of polymorphic VT is Torsade de pointes.
ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) [1]
| Class I |
| "1. Direct current cardioversion with appropriate sedation as necessary is recommended for patients with sustained polymorphic VT with hemodynamic compromise and is reasonable at any point in the treatment cascade. (Level of Evidence: B). " |
| "2. Intravenous beta blockers are useful for patients with recurrent polymorphic VT especially if ischemia is suspected or cannot be excluded. (Level of Evidence: B). " |
| "3. Intravenous loading with amiodarone is useful for patients with recurrent polymorphic VT in the absence of abnormal repolarization related to congenital or acquired LQTS. (Level of Evidence: C). " |
| "4. Urgent angiography with a view to revascularization should be considered for patients with polymorphic VT when myocardial ischemia cannot be excluded. (Level of Evidence: C). " |
| Class IIb |
| "1. Intravenous lidocaine may be reasonable for treatment of polymorphic VT specifically associated with acute myocardial ischemia or infarction. (Level of Evidence: C)" |
References
- ↑ Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M; et al. (2006). "ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (10): e385–484. doi:10.1161/CIRCULATIONAHA.106.178233. PMID 16935995.