- 期刊
Torsades de Pointes: A Report of Eleven Cases
多形性心室頻脈（Torsades de Pointes）：11位病例分析報告
摘要
Torsades de pointes是一種特殊形態的多形性心室頻脈，其心電圖的特徵包括：QRS波的形態會一直改變，彷彿纏繞著一條假想的線；另外它的發作常與心博過緩有關，合併有QT間距延長，及以所謂「長-短」的序列而開始。 齡是58.5±14.3歲。有9個患者是以暈厥表現，另2個患者則是以癲癇表現。在心律不整發作時，平均的QT間距是647.1±79.9毫秒。統計其相關的誘發因素，發現在11 個病例中以電解質異常的比例最高，占10例。4個病例是慢性肝炎或肝硬化，3例是併有冠狀動脈心臟病，2例是房室傳導完全阻滯；另外一些常用藥物的使用，也可能與此種心律不整有關。如：cisapride,terfenadine;quinidine and erythromycin等。 因此，對於此種心律不整的防範，是要了解其誘發因素，小心使用這些具潛在危險的藥物。而處理上，則須保持高度懷疑，及早診斷與處理，去除其誘發因素，通常病人的預後不錯。
並列摘要
Torsades de pointes is a special form of polymorphic ventricular tachycardia. It is characterized by continuously changing morphology of the QRS complexes that seem to twist around an imaginary line, rate dependence, underlying QT prolongation and the so called “long-short initiation sequence”. We retrospectively studied eleven cases of torsades de pointes which were confirmed to be acquired from September 1996 to October 1999. The patients included eight women and three men, with a mean age of 58.5±14.3 years. Nine patients presented with syncope and the other two with seizure. The mean corrected QT interval during arrhythmic episodes was 647.1±79.9msecs. The associated underlying prob-lems included electrolyte imbalance, complete AV block, liver cirrhosis and use of medications, such as erythromycin, quinidine, terfenadine and cisapride. All patients were free from arrhythmia after treatment, but one patient died later due to liver failure.