Prolonged Q-T Syndrome
Treatments for Torsades Patients
& maintenance for Torsades:
implantation of an AICD Defibrillator/pacemaker by a competent
electrophysiologist with Torsades experience is a necessary treatment as well as
a sudden cardiac death preventative measure. St Jude has one of the most
reliable AICDís for Torsades and prolonged Q-T patients.
should follow the same guidelines listed above for Surgeons and
anesthesiologists. Torsades patients AICD surgeries should not be performed
outside of a hospital setting due to the issues with sterile requirements and
inability to use common antibiotics.
who are not fully experienced with Torsades, often fail to set the AICD minimum
heart pacing rate to match the expected equivalent average resting heart rate
levels appropriate to the gender, age and patient specifics. By overlooking the
Torsades patientís potential for prolonged Q-T and heart rate drop, the AICD
is often left at the default or low setting such as 50 BPM. Subsequently, the
Torsades patient can experience frequent dizziness, nausea & syncope from
the fluctuating heart rate levels. (as an example: I am a female Torsades
patient with a St Jude AICD. A less experienced electrophysiologist had left my
AICD defaulted to 50 BPM, which caused syncope (fainting) & vertigo as my
heart rate fluctuated up and down. My current electrophysiologist with extensive
Torsades & prolonged Q-T experience corrected my AICD minimum heart rate
pace setting to 75 bpm.)
setting the AICD upper heart rate shock level, keep in mind the heart rate
levels generated during cardiac diagnostic nuclear stress tests. You would not
want your patient to receive a defibrillator shock during a standard treadmill
test or impair the heart rate levels required to conduct a thorough nuclear
stress test diagnostic.
sure to verbally discuss the doís and doníts for post implant surgery
patients and ongoing precautions. Provide a written list for the patients
reference as well but donít depend on the patient to read the instructions.
Torsades patient with an AICD should be seen by the electrophysiologist no less
than every 6 months or more frequently as appropriate to the stability of their
condition. Be sure to print out a record of the histories, settings and events
stored in the AICD during each visit. Evaluation of the AICD readings, events
& records should be performed by the Electrophysiologist, not an assistant.
Additional home monitoring & reporting, portable Fib and heart loop monitors
and other devices are always options to supplement the patientís care.
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