Out-of-hospital pleomorphic ventricular tachycardia and resuscitation: Association with acute myocardial ischemia and infarction

Roger D. White, Douglas L. Wood

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Pleomorphic ventricular tachycardia is characterized by QRS complexes with repeated variation in polarity, amplitude, and regularity. When associated with prolongation of the QT interval, the term torsades de pointes is used to describe the arrhythmia. It usually is seen clinically in association with class IA antiarrhythmic drugs such as quinidine and procainamide, bradycardia, hypokalemia, and, much less often, other drugs and electrolyte disorders as well as a result of congenital and neurogenic causes. It also may accompany acute myocardial infarction or ischemia. We describe four patients in whom pleomorphic ventricular tachycardia was observed as the presenting rhythm or during the course of resuscitation in out-of-hospital cardiac arrest. In all four patients, acute myocardial ischemia appeared to be the provocative mechanism. Therapeutic implications include an awareness of the unusual behavior of this arrhythmia, especially its propensity to terminate spontaneously. Such awareness may prevent the delivery of unnecessary defibrillatory shocks.

Original languageEnglish (US)
Pages (from-to)1282-1287
Number of pages6
JournalAnnals of Emergency Medicine
Volume21
Issue number10
DOIs
StatePublished - 1992

Fingerprint

Ventricular Tachycardia
Resuscitation
Myocardial Ischemia
Cardiac Arrhythmias
Myocardial Infarction
Out-of-Hospital Cardiac Arrest
Procainamide
Torsades de Pointes
Quinidine
Hypokalemia
Anti-Arrhythmia Agents
Bradycardia
Electrolytes
Shock
Pharmaceutical Preparations
Therapeutics

Keywords

  • pleomorphic ventricular tachycardia
  • torsades de pointes

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Out-of-hospital pleomorphic ventricular tachycardia and resuscitation : Association with acute myocardial ischemia and infarction. / White, Roger D.; Wood, Douglas L.

In: Annals of Emergency Medicine, Vol. 21, No. 10, 1992, p. 1282-1287.

Research output: Contribution to journalArticle

@article{2cac3171a7404ad4baceb21fd48eace3,
title = "Out-of-hospital pleomorphic ventricular tachycardia and resuscitation: Association with acute myocardial ischemia and infarction",
abstract = "Pleomorphic ventricular tachycardia is characterized by QRS complexes with repeated variation in polarity, amplitude, and regularity. When associated with prolongation of the QT interval, the term torsades de pointes is used to describe the arrhythmia. It usually is seen clinically in association with class IA antiarrhythmic drugs such as quinidine and procainamide, bradycardia, hypokalemia, and, much less often, other drugs and electrolyte disorders as well as a result of congenital and neurogenic causes. It also may accompany acute myocardial infarction or ischemia. We describe four patients in whom pleomorphic ventricular tachycardia was observed as the presenting rhythm or during the course of resuscitation in out-of-hospital cardiac arrest. In all four patients, acute myocardial ischemia appeared to be the provocative mechanism. Therapeutic implications include an awareness of the unusual behavior of this arrhythmia, especially its propensity to terminate spontaneously. Such awareness may prevent the delivery of unnecessary defibrillatory shocks.",
keywords = "pleomorphic ventricular tachycardia, torsades de pointes",
author = "White, {Roger D.} and Wood, {Douglas L.}",
year = "1992",
doi = "10.1016/S0196-0644(05)81767-6",
language = "English (US)",
volume = "21",
pages = "1282--1287",
journal = "Annals of Emergency Medicine",
issn = "0196-0644",
publisher = "Mosby Inc.",
number = "10",

}

TY - JOUR

T1 - Out-of-hospital pleomorphic ventricular tachycardia and resuscitation

T2 - Association with acute myocardial ischemia and infarction

AU - White, Roger D.

AU - Wood, Douglas L.

PY - 1992

Y1 - 1992

N2 - Pleomorphic ventricular tachycardia is characterized by QRS complexes with repeated variation in polarity, amplitude, and regularity. When associated with prolongation of the QT interval, the term torsades de pointes is used to describe the arrhythmia. It usually is seen clinically in association with class IA antiarrhythmic drugs such as quinidine and procainamide, bradycardia, hypokalemia, and, much less often, other drugs and electrolyte disorders as well as a result of congenital and neurogenic causes. It also may accompany acute myocardial infarction or ischemia. We describe four patients in whom pleomorphic ventricular tachycardia was observed as the presenting rhythm or during the course of resuscitation in out-of-hospital cardiac arrest. In all four patients, acute myocardial ischemia appeared to be the provocative mechanism. Therapeutic implications include an awareness of the unusual behavior of this arrhythmia, especially its propensity to terminate spontaneously. Such awareness may prevent the delivery of unnecessary defibrillatory shocks.

AB - Pleomorphic ventricular tachycardia is characterized by QRS complexes with repeated variation in polarity, amplitude, and regularity. When associated with prolongation of the QT interval, the term torsades de pointes is used to describe the arrhythmia. It usually is seen clinically in association with class IA antiarrhythmic drugs such as quinidine and procainamide, bradycardia, hypokalemia, and, much less often, other drugs and electrolyte disorders as well as a result of congenital and neurogenic causes. It also may accompany acute myocardial infarction or ischemia. We describe four patients in whom pleomorphic ventricular tachycardia was observed as the presenting rhythm or during the course of resuscitation in out-of-hospital cardiac arrest. In all four patients, acute myocardial ischemia appeared to be the provocative mechanism. Therapeutic implications include an awareness of the unusual behavior of this arrhythmia, especially its propensity to terminate spontaneously. Such awareness may prevent the delivery of unnecessary defibrillatory shocks.

KW - pleomorphic ventricular tachycardia

KW - torsades de pointes

UR - http://www.scopus.com/inward/record.url?scp=0026644724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026644724&partnerID=8YFLogxK

U2 - 10.1016/S0196-0644(05)81767-6

DO - 10.1016/S0196-0644(05)81767-6

M3 - Article

C2 - 1416316

AN - SCOPUS:0026644724

VL - 21

SP - 1282

EP - 1287

JO - Annals of Emergency Medicine

JF - Annals of Emergency Medicine

SN - 0196-0644

IS - 10

ER -