WordNet

mark with diacritics; "point the letter"
a very small circular shape; "a row of points"; "draw lines between the dots" (同)dot
an instant of time; "at that point I had to leave" (同)point in time
repair the joints of bricks; "point a chimney" (同)repoint
a V shape; "the cannibals teeth were filed to sharp points" (同)tip, peak
a linear unit used to measure the size of type; approximately 1/72 inch
a style in speech or writing that arrests attention and has a penetrating or convincing quality or effect
one percent of the total principal of a loan; it is paid at the time the loan is made and is independent of the interest on the loan
the unit of counting in scoring a game or contest; "he scored 20 points in the first half"; "a touchdown counts 6 points"
the gun muzzles direction; "he held me up at the point of a gun" (同)gunpoint
the property of a shape that tapers to a sharp tip (同)pointedness
a wall socket (同)power_point
an outstanding characteristic; "his acting was one of the high points of the movie" (同)spot
a distinguishing or individuating characteristic; "he knows my bad points as well as my good points"
sharp end; "he stuck the point of the knife into a tree"; "he broke the point of his pencil"
a V-shaped mark at one end of an arrow pointer; "the point of the arrow was due north" (同)head
a brief version of the essential meaning of something; "get to the point"; "he missed the point of the joke"; "life has lost its point"
a geometric element that has position but no extension; "a point is defined by its coordinates"
a promontory extending out into a large body of water; "they sailed south around the point"
the object of an activity; "what is the point of discussing it?"
the precise location of something; a spatially limited location; "she walked to a point where she could survey the whole street"
be positionable in a specified manner; "The gun points with ease"
indicate the presence of (game) by standing and pointing with the muzzle; "the dog pointed the dead duck"
mark (a psalm text) to indicate the points at which the music changes
mark (Hebrew words) with diacritics
a legal document signed and sealed and delivered to effect a transfer of property and to show the legal right to possess it; "he signed the deed"; "he kept the title to his car in the glove compartment" (同)deed of conveyance, title
go `ding dong, like a bell (同)dong, dingdong
a ringing sound

PrepTutorEJDIC

〈C〉(針・鉛筆・剣などの)『とがった先』,(…の)先端《+『of』+『名』》 / 〈C〉岬(みさき) / 〈C〉(小数点・句読点などの)点 / 〈C〉(図形上の)点 / 〈C〉(ある特定の)『地点』(spot),場所(place) / 〈C〉(計器の目盛りなどの)『点』,『度』 / 〈C〉時点,瞬間 / 〈C〉《単数形で》(物語・議論などの)『要点』,核心《+『of』(『in』)+『名』》 / 〈U〉(…の)『目的』,『意義』,ねらっている点《+『of』(『in』)+『名』(do『ing』)》 / 〈C〉(全体の中の)個々の項目,細目(item),細部(detail) / 〈C〉特徴(characteristic),特質(trait) / 〈C〉(競技・学校の成績などの)得点 / 〈C〉ポイント(活字の大きさの単位;約1/72インチの大きさ) / (…に)〈銃・指など〉‘を'『向ける』《+『名』+『at』(『to, toward』)+『名』》 / …‘に'『指し示す』《point+名+to+名…に…をさし示す》 / …‘の'先をとがらせる,‘に'先を付ける / …‘に'点を打つ;…‘に'小数点を付ける;…‘に'句読点を付ける / 〈猟犬が〉〈獲物〉‘を'指し示す / (…を)(指などで)『示す』,指し示す《+『at』(『to, toward』)+『名』(do『ing』)》 / 〈猟犬が〉獲物の位置を示す
『行為』,行動 / (正式の)捺印証書,権利書 / …'を'証書を作製して譲渡する
〈鐘など〉‘を'ガンガン鳴らす / 〈鐘などが〉ガンガン鳴る / (鐘の)ガンガン鳴る音
(おもに人称代名詞・固有名詞(人名),thereの後で)had, wouldの短縮形 / (疑問文でwhere,what,whenの後で)didの短縮形;Where'd he go?=Where did he go?
Delaware

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/06/21 01:09:43」(JST)

wiki en

Torsades de pointes or torsade de pointes (TdP or simply torsade(s)) (French: [tɔʁsad də pwɛ̃t], translated as "twisting of the points"), is a specific type of abnormal heart rhythm that can lead to sudden cardiac death. It is a polymorphic ventricular tachycardia that exhibits distinct characteristics on the electrocardiogram (ECG). It was described by Dessertenne in 1966.^[1] Prolongation of the QT interval can increase a person's risk of developing this abnormal heart rhythm.

Signs and symptoms

Most episodes revert spontaneously to a normal sinus rhythm. Other possible outcomes include palpitations, dizziness, lightheadedness (short episodes), fainting (longer episodes), and sudden cardiac death.

Causes

Common causes for torsades de pointes include diarrhea, low blood magnesium, and low blood potassium. It is commonly seen in malnourished individuals and chronic alcoholics since they are often deficient in potassium and/or magnesium. Certain combinations of drugs resulting in drug interactions can contribute to torsades de pointes risk. QT prolonging medications such as clarithromycin, levofloxacin, or haloperidol, when taken at the same time as a specific cytochrome P450 inhibitor such as fluoxetine, cimetidine or foods like grapefruit, can result in higher than normal levels of QT prolonging medications in the bloodstream and increase a person's risk of developing torsades de pointes. In addition, inherited long QT syndrome significantly increases the risk of episodes of torsades de pointes.

Prescription drug interactions

TdP as a prescription drug side effect has been a major liability and reason for withdrawal of medications from the marketplace.^[2] Examples of compounds linked to clinical observations of TdP include amiodarone, fluoroquinolones, methadone, lithium, chloroquine, erythromycin, amphetamine, ephedrine, pseudoephedrine, methylphenidate, and phenothiazines.^[3] It can also be the side effect of some antiarrhythmic medications such as sotalol, procainamide, and quinidine. The gastrokinetic drug cisapride (Propulsid) was withdrawn from the US market in 2000 after such interactions led to deaths caused by long QT syndrome-induced torsades de pointes. In many cases this effect can be directly linked to QT prolongation mediated predominant by inhibition of the hERG channel.

In September 2011 (subsequently updated in March 2012 and February 2013), the FDA issued a warning concerning increased incidence of QT elongation with doses of the antidepressant Celexa (citalopram) above 40 mg per day, which is considered the maximum allowable dosage, increasing the risk of Torsades.^[4]^[5] However, the study, "Evaluation of the FDA Warning Against Prescribing Citalopram at Doses Exceeding 40 mg" reported no increased risk of abnormal arrhythmias thus questioning the merit of the FDA warning.^[6]

Risk factors

The following is a list of factors associated with an increased tendency toward torsades de pointes:^{[medical citation needed]}

Lead II ECG showing torsades being shocked by an implantable cardioverter-defibrillator back to the patient's baseline cardiac rhythm.

Hypokalemia (low blood potassium)
Hypomagnesemia (low blood magnesium)
Hypocalcemia (low blood calcium)
Bradycardia (slow heartbeat)
Heart failure
Left ventricular hypertrophy
Hypothermia
Subarachnoid hemorrhage
Hypothyroidism

Diagnosis

The ECG tracing in torsades demonstrates a polymorphic ventricular tachycardia with a characteristic illusion of a twisting of the QRS complex around the isoelectric baseline (peaks which are at first pointing up are seen to be pointing down for subsequent "beats" when looking at ECG traces of the "heartbeat"). It is hemodynamically unstable and causes a sudden drop in arterial blood pressure, leading to dizziness and fainting. Depending on their cause, most individual episodes of torsades de pointes revert to normal sinus rhythm within a few seconds, but may also persist and possibly degenerate into ventricular fibrillation, which will lead to sudden death in the absence of prompt medical intervention. Torsades de pointes is associated with long QT syndrome, a condition whereby prolonged QT intervals are visible on the ECG. Long QT intervals predispose the patient to an R-on-T phenomenon, where the R wave representing ventricular depolarization occurs during the relative refractory period at the end of repolarization (represented by the latter half of the T-wave). An R-on-T can initiate torsades. Sometimes pathologic T-U waves may be seen in the ECG before the initiation of torsades.^[7]

A "short-coupled variant of torsade de pointes", which presents without long QT syndrome, was also described in 1994.^[8]

Drastic rotation of the heart's electrical axis
Prolonged QT interval (LQTS) - may not be present in the short-coupled variant of torsade de pointes
Preceded by long and short RR-intervals - not present in the short-coupled variant of torsade de pointes
Triggered by a premature ventricular contraction (R-on-T PVC)

Treatment

Treatment is directed at withdrawal of the offending agent, infusion of magnesium sulfate,^[9]^[10] antiarrhythmic drugs, and electrical therapy such as a temporary pacemaker as needed.

Because of the polymorphic nature of torsades de pointes, synchronized cardioversion may not be possible, and the patient may require an unsynchronized shock (or defibrillation).

History

The phenomenon was originally described in a French medical journal by Dessertenne in 1966, when he observed this cardiac rhythm disorder in an 80-year-old female patient with complete intermittent atrioventricular block. In coining the term, he referred his colleagues to the "Dictionnaire Le Robert," a bilingual French English dictionary, of which his wife had just given him a copy. Here "torsade" is defined as (a)a bundle of threads twisted in a helix or spiral, for ornamental purposes, as in an Aran sweater; (b) long hair twisted together, or (c) an ornamental motif as seen on architectural columns.

The singular and plural forms (torsade de pointes and torsades de pointes) have both often been used. The question of whether either one is "correct" and the other "incorrect" has repeatedly arisen. Among major medical dictionaries, one enters only the plural form, another enters the plural form as the headword but lists the singular as a variant, and another enters the singular form as the headword and gives a usage comment saying that the plural is not preferred. One group of physicians suggests^[11] that it would make sense to use the singular form as the general entity name (whether comprising a single or repeated episodes) and that one might best reserve the plural form for describing repeated twistings during a single episode. Regarding the natural language variation, they conclude good-naturedly, "Wasn't it the French who coined the term 'vive la difference?'"^[11]

References

^ Dessertenne, F. (1966). "La tachycardie ventriculaire a deux foyers opposes variables". Archives des maladies du coeur et des vaisseaux (in French) 59 (2): 263–272. ISSN 0003-9683. PMID 4956181. Prepaired by Rahel farhad
^ Labant, MaryAnn (November 15, 2014). "Weaving a Stronger Drug Safety Net". Gen. Eng. Biotechnol. News (paper) 34 (20). p. 1.
^ "Drugs That Prolong the QT Interval or Induce Torsades de Pointes". Point of Care Quick Reference. American Academy of Pediatrics. March 11, 2010. Archived from the original on March 7, 2014.
^ "FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses" (Press release). USFDA. February 15, 2013. Retrieved December 13, 2014.
^ Deshmukh, Anand; Ulveling, Kyle; et al. (2012). "Prolonged QTc interval and torsades de pointes induced by citalopram". Tex. Heart Inst. J. 39 (1): 68–70. PMC 3298934. PMID 22412232.
^ K Zivin; PN Pfeiffer; ASB Bohnert; D Ganoczy; FC Blow; BK Nallamothu; HC Kales (June 1, 2013). "Evaluation of the FDA Warning Against Prescribing Citalopram at Doses Exceeding 40 mg". Am J Psychiatry 170 (6): 642–650. doi:10.1176/appi.ajp.2013.12030408. PMID 23640689.
^ John, J.; Amley, X.; Bombino, G.; Gitelis, C.; Topi, B.; Hollander, G.; Ghosh, J. (2010). "Torsade de Pointes due to Methadone Use in a Patient with HIV and Hepatitis C Coinfection". Cardiology Research and Practice 2010: 1–4. doi:10.4061/2010/524764. PMC 3021856. PMID 21253542.
^ Leenhardt A, Glaser E, Burguera M, Nürnberg M, Maison-Blanche P, Coumel P (January 1994). "Short-coupled variant of torsade de pointes. A new electrocardiographic entity in the spectrum of idiopathic ventricular tachyarrhythmias" (PDF). Circulation 89 (1): 206–15. doi:10.1161/01.CIR.89.1.206. PMID 8281648.
^ Hoshino, Kenji; Ogawa Kiyoshi; et al. (October 2004). "Optimal administration dosage of magnesium sulfate for torsades de pointes in children with long QT syndrome". J. Am. Coll. Nutr. 23 (5): 497S–500S. doi:10.1080/07315724.2004.10719388. PMID 15466950.
^ Hoshino, Kenji; Ogawa, Kiyoshi; et al. (April 2006). "Successful uses of magnesium sulfate for torsades de pointes in children with long QT syndrome". Pediatr. Int. 48 (2): 112–7. doi:10.1111/j.1442-200X.2006.02177.x. PMID 16635167.
^ ^a ^b Moise NS (1999), "As Americans, we should get this right [correspondence and response]", Circulation 100: 1462, doi:10.1161/01.CIR.100.13.1462.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 頻脈性不整脈の急性期マネージメントの概要 overview of the acute management of tachyarrhythmias
2. 後天性ＱＴ延長症候群 acquired long qt syndrome
3. I群抗不整脈薬の主な副作用 major side effects of class i antiarrhythmic drugs
4. 心電図チュートリアル：心室性不整脈 ecg tutorial ventricular arrhythmias
5. 先天性QT延長症候群の臨床的特徴 clinical features of congenital long qt syndrome

English Journal

A new functional data-based biomarker for monitoring cardiovascular behavior.

Zhou Y, Sedransk N.SourceEast China Normal University, Shanghai, China.
Statistics in medicine.Stat Med.2013 Jan 15;32(1):153-64. doi: 10.1002/sim.5518. Epub 2012 Aug 8.
Cardiac safety assessment in drug development concerns the ventricular repolarization (represented by electrocardiogram (ECG) T-wave) abnormalities of a cardiac cycle, which are widely believed to be linked with torsades de pointes, a potentially life-threatening arrhythmia. The most often used biom
PMID 22886476

[A case of electrical storm in a patient with short-coupled variant of torsade de pointes].

Conte G, Coppini L, Demola MA, Ardissino D.AbstractShort-coupled variant of torsade de pointes (TdP) is an uncommon variant of polymorphic ventricular tachycardia with unknown etiology. It is initiated by a closely coupled premature ventricular complex (<300 ms) in the absence of QT prolongation and structural heart disease. Verapamil seems to be the only drug able to suppress the arrhythmia but, as it does not reduce the risk of sudden death, implantation of a cardioverter-defibrillator (ICD) is recommended. We describe the case of a 46-year-old woman referred to our Emergency Department because of palpitations. The initial ECG showed a non-sustained polymorphic ventricular tachycardia with a borderline QTc interval (450 ms). After admission, the patient experienced an episode of TdP that started after short-coupling interval (280 ms) between the last sinus beat and the ventricular premature beat (VPB). DC-shock restored sinus rhythm. Physical examination, exercise testing, echocardiography and cardiac magnetic resonance were all normal, and she had no family history of sudden cardiac death. Baseline ECG showed sinus rhythm and unifocal VPBs with the same morphology of the VPB of TdP. The patient received an ICD and was treated medically with verapamil. She was discharged from the hospital on oral therapy with verapamil (240 mg/day), and she was free of recurrence 12 months later when an electrical storm occurred. The verapamil dose was therefore increased to 480 mg/day. Unifocal VPBs disappeared from her body surface ECG, and the subsequent 3-year follow-up was uneventful.
Giornale italiano di cardiologia (2006).G Ital Cardiol (Rome).2013 Jan;14(1):76-8. doi: 10.1714/1207.13375.
Short-coupled variant of torsade de pointes (TdP) is an uncommon variant of polymorphic ventricular tachycardia with unknown etiology. It is initiated by a closely coupled premature ventricular complex (<300 ms) in the absence of QT prolongation and structural heart disease. Verapamil seems to be
PMID 23258207

A novel, potent, and selective inhibitor of cardiac late sodium current suppresses experimental arrhythmias.

Belardinelli L, Liu G, Smith-Maxwell C, Wang WQ, El-Bizri N, Hirakawa R, Karpinski S, Hong Li C, Hu L, Li XJ, Crumb W, Wu L, Koltun D, Zablocki J, Yao L, Dhalla AK, Rajamani S, Shryock JC.SourceMD Gilead Sciences, Inc., 333 Lakeside Drive, Foster City, CA 94404. luiz.belardinelli@gilead.com.
The Journal of pharmacology and experimental therapeutics.J Pharmacol Exp Ther.2013 Jan;344(1):23-32. doi: 10.1124/jpet.112.198887. Epub 2012 Sep 25.
Inhibition of cardiac late sodium current (late I(Na)) is a strategy to suppress arrhythmias and sodium-dependent calcium overload associated with myocardial ischemia and heart failure. Current inhibitors of late I(Na) are unselective and can be proarrhythmic. This study introduces GS967 (6-[4-(trif
PMID 23010360

Japanese Journal

院内急変対応の実際--気道・呼吸・循環・神経急変の実例とその対処法について (特集院内急変対応) -- (症例から学ぶ院内急変対応)

遠藤智之,久志本成樹
救急医学 35(9), 1063-1067, 2011-09
NAID 40018978456

麻酔導入時の高度徐脈に伴い多型性心室性頻拍を生じた1症例

濱口英佑,河野裕明,川人伸二 [他]
麻酔 60(9), 1097-1100, 2011-09
NAID 40018967038

Related Pictures

★リンクテーブル★

リンク元	「電解質異常」「トルサード・ド・ポアンツ」
関連記事	「point」「DE」

「電解質異常」

Torsades de pointes
	12-lead ECG of Torsades de Pointes (TdP) in a 56-year-old white female with low blood potassium (2.4 mmol/L) and low blood magnesium (1.6 mg/dL.)
Classification and external resources
Specialty	Cardiology
DiseasesDB	29252
eMedicine	med/2286 emerg/596
Patient UK	Torsades de pointes
MeSH	D016171
	[edit on Wikidata]

　　[★]

英: electrolyte abnormality
同: 電解質失調 electrolyte disturbance、電解質平衡異常 electrolyte imbalance
関: 確認テスト電解質

see 電解質異常.xls

基準値

			臨床検査法提要第32版		施設基準値
Na+			136～145	mEq/l	138～145	mEq/ｌ
K+			3.4～4.5	mEq/l	3.5～4.8	mEq/ｌ
Cl-			100～108	mEq/l	99～107	mEq/ｌ
HCO3-			22～26	mEq/l
アニオンギャップ			12±4	mEq/l
総Ca			8.6～10.1	mg/dl	8.8～10.0	mg/dl
イオン化Ca			1.15～1.30	mmol/l
無機リン	IP	成人	2.2～4.1	mg/dl	2.7～4.5	mg/dl
		小児	4.0～7.0
Mg			1.8～2.3	mg/dl	1.8～2.4	mg/dl

心電図との関連

also see YN.D-149

	高	低
カリウム	高カリウム血症	低カリウム血症
カリウム	テント状T	T波平坦化 U波出現
カルシウム	高カルシウム血症	低カルシウム血症
カルシウム	QT短縮	QT延長
マグネシウム	高マグネシウム血症	低マグネシウム血症
マグネシウム		QT延長

カリウム

高カリウム血症 YN.D-142

テント状T、P波消失、QRS延長、サインカーブ、心室細動

静止膜電位の上昇(脱分極)

QRS波延長：(伝導速度の低下)細胞外K濃度が高い→活性化状態にあるNaチャネルが少なく、心筋細胞の脱分極第0相におけるNaの流入速度が低下→活動電位発生の時間が遷延

低カリウム血症 YN.D-141

T波の減高、U波の出現、ST低下、陰性T波

静止膜電位の低下(過分極)

QRS幅延長?????

カルシウム

高カルシウム血症

QT短縮(ST短縮)

カルシウムの流入速度が速くなる？

QRS幅拡大することがある

低カルシウム血症

QT延長(ST延長)、心収縮力低下。QRSの延長なし

カルシウムの流入速度が遅くなる感じ？

低Ca血症+低Mg血症でAPD延長と早期後脱分極(EAD)によるtorsade de pointesのリスクが高まる

QRS幅は変化なし

マグネシウム

高マグネシウム血症

低マグネシウム血症

QT延長

「トルサード・ド・ポアンツ」

　　[★]

仏: Torsades de pointes, torsades de pointes, torsade de pointes
同: トルサード・ド・ポアンツ、トルサード・ド・ポアン、倒錯型心室頻拍、倒錯性心室頻拍、多形性心室頻拍 polymorphic ventricular tachycardia
関: QT延長症候群

[show details]

トルサード・ド・ポアン : 87 件
トルサード・ド・ポアント : 60 件
トルサード・ド・ポアンツ : 81 件
トルサードドポアント : 60 件

概念

多形性心室頻拍であって、非発作時にはQT延長を伴うものである。
心電図上、多形性心室頻拍を示し、QRSがベースラインに対して反転した波形で周期的に変動する。

疫学

SQ.549

性差：女性に多い
好発年齢：35-50歳

病因

QT延長症

病態

心拍数減少により失神・痙攣を来す。
短時間のうちに頻拍が停止し、回復することもまれならずある。

治療

QT延長が原因であればMgを静注。
QT延長の原因によって次の治療を行う。

先天性QT延長症候群：β遮断薬
後天性QT延長症候群：心室ペーシング(一時的ペーシング)

YN.C-49

原因の除去、硫酸マグネシウム→メキシレチン
薬物療法無効であれば体外式ペーシング。

予防

先天性QT延長症候群：β遮断薬、ICD
後天性QT延長症候群：QT延長の治療

参考

1. 不整脈薬物治療に関するガイドライン（2009年改訂版）

[display]http://www.j-circ.or.jp/guideline/pdf/JCS2009_kodama_h.pdf

「point」

　　[★]

vt.
vi.

指さす、示す(at,to)
(ある方向に)向いている(to,toward)
傾向にある(to)

n.

関: dictate、direct、dot、indicate、indication、instruct、instruction、spot

「DE」

　　[★] 線量当量 dose equivalent 　

[1] Dessertenne, F. (1966). "La tachycardie ventriculaire a deux foyers opposes variables". Archives des maladies du coeur et des vaisseaux (in French) 59 (2): 263–272. ISSN 0003-9683. PMID 4956181. Prepaired by Rahel farhad

[labant2014-2] Labant, MaryAnn (November 15, 2014). "Weaving a Stronger Drug Safety Net". Gen. Eng. Biotechnol. News (paper) 34 (20). p. 1.

[pcqr_tpd-3] "Drugs That Prolong the QT Interval or Induce Torsades de Pointes". Point of Care Quick Reference. American Academy of Pediatrics. March 11, 2010. Archived from the original on March 7, 2014.

[fdapr_celexa-4] "FDA Drug Safety Communication: Revised recommendations for Celexa (citalopram hydrobromide) related to a potential risk of abnormal heart rhythms with high doses" (Press release). USFDA. February 15, 2013. Retrieved December 13, 2014.

[deshmukh_ulveling-5] Deshmukh, Anand; Ulveling, Kyle; et al. (2012). "Prolonged QTc interval and torsades de pointes induced by citalopram". Tex. Heart Inst. J. 39 (1): 68–70. PMC 3298934. PMID 22412232.

[6] K Zivin; PN Pfeiffer; ASB Bohnert; D Ganoczy; FC Blow; BK Nallamothu; HC Kales (June 1, 2013). "Evaluation of the FDA Warning Against Prescribing Citalopram at Doses Exceeding 40 mg". Am J Psychiatry 170 (6): 642–650. doi:10.1176/appi.ajp.2013.12030408. PMID 23640689.

[pmc-7] John, J.; Amley, X.; Bombino, G.; Gitelis, C.; Topi, B.; Hollander, G.; Ghosh, J. (2010). "Torsade de Pointes due to Methadone Use in a Patient with HIV and Hepatitis C Coinfection". Cardiology Research and Practice 2010: 1–4. doi:10.4061/2010/524764. PMC 3021856. PMID 21253542.

[pmid-8] Leenhardt A, Glaser E, Burguera M, Nürnberg M, Maison-Blanche P, Coumel P (January 1994). "Short-coupled variant of torsade de pointes. A new electrocardiographic entity in the spectrum of idiopathic ventricular tachyarrhythmias" (PDF). Circulation 89 (1): 206–15. doi:10.1161/01.CIR.89.1.206. PMID 8281648.

[pmid15466950-9] Hoshino, Kenji; Ogawa Kiyoshi; et al. (October 2004). "Optimal administration dosage of magnesium sulfate for torsades de pointes in children with long QT syndrome". J. Am. Coll. Nutr. 23 (5): 497S–500S. doi:10.1080/07315724.2004.10719388. PMID 15466950.

[pmid16635167-10] Hoshino, Kenji; Ogawa, Kiyoshi; et al. (April 2006). "Successful uses of magnesium sulfate for torsades de pointes in children with long QT syndrome". Pediatr. Int. 48 (2): 112–7. doi:10.1111/j.1442-200X.2006.02177.x. PMID 16635167.

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torsade de pointes