Torsade De Pointes, an atypical ventricular tachycardia.

When defining a 'new' arrhythmia it is reasonable electrocardiography or arrhythmias. If, however, to suppose that it may indeed have been recognized we turn to the French literature for authoritative many years previously. This applies to the disorder reviews (Brochier, Motte, and Fauchier, 1972; now called torsade de pointes, whose features have Slama et al., 1973; Puech, 1974), apparently obscure been so well worked out since it was characterized ventricular tachyarrhythmias that have proved by Dessertenne (1966, 1967). As the opening quotadifficult to classify become understandable (Bleifer tion implies, why introduce a new name? The et al., 1974; Pilling and Nanton, 1974; Meijler, specific characteristics of this arrhythmia are Robles de Medina, and Zimmerman, 1975; poorly recognized in English and American reports Schamroth, 1975). and the importance of principles relating to its aetiology and management are so crucial that it Diagnostic features deserves to be better known; as its mechanism is Diagosti features not yet quite clear a morphological name seems Te m am maticave bees Krized 1974de more appropriate. Reference to a standard Frenchpicted diagrammatically elsewhere (Krikler, 1974). English dictionary (Harrap's New Shorter French The diagnosis is made from the electrocardiographic andEnglish Dictionary, 1967) shows howwelltorsade appearances both during and between attacks andEnginshDictiontary,1967shows howwelltorsadev and from any aetiological factors (Slama et al., de pointes describes the appearances: 'torsade., twisted 1973). The specific findings (best seen when fringe, . . . twist, coil, . . thick bullion (of epaulet); multhe speous leadsarestaken when pointe, point (of pin, sword, etc.), tip, head (of multiple simultaneous leads are taken) consist of arrow, lance).. .'. Its use in French is much more paroxysms of ventricular tachycardia in which the euphonious than translations like 'wave bursts'. QRS axis undulates over runs of 5 to 20 beats, with Though the electrocardiographic features were definite changes in direction (Fig.). This has led first noted more than 50 years ago (MacWilliam, to the use of a variety of descriptive terms for what