Which intervention is preferred for torsades de pointes?

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Multiple Choice

Which intervention is preferred for torsades de pointes?

Explanation:
Torsades de pointes is a form of ventricular tachycardia tied to QT interval prolongation. The treatment of choice is intravenous magnesium sulfate, given even if magnesium levels are normal. Magnesium helps stabilize the cardiac cell membranes and suppress early afterdepolarizations that trigger and sustain torsades, effectively reducing the tendency for the abnormal twisting of the QRS complexes. The rapid IV dose of 1–2 g over 1–2 minutes acts quickly to counteract the arrhythmia, with the option to maintain with a slower infusion if needed. Other antiarrhythmics are not as helpful here and can be detrimental: amiodarone tends to prolong the QT interval and may worsen torsades; lidocaine and procainamide are not targeted therapies for torsades and can also contribute to QT prolongation or be ineffective in this specific mechanism.

Torsades de pointes is a form of ventricular tachycardia tied to QT interval prolongation. The treatment of choice is intravenous magnesium sulfate, given even if magnesium levels are normal. Magnesium helps stabilize the cardiac cell membranes and suppress early afterdepolarizations that trigger and sustain torsades, effectively reducing the tendency for the abnormal twisting of the QRS complexes. The rapid IV dose of 1–2 g over 1–2 minutes acts quickly to counteract the arrhythmia, with the option to maintain with a slower infusion if needed.

Other antiarrhythmics are not as helpful here and can be detrimental: amiodarone tends to prolong the QT interval and may worsen torsades; lidocaine and procainamide are not targeted therapies for torsades and can also contribute to QT prolongation or be ineffective in this specific mechanism.

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