Optimal Administration Dosage of Magnesium Sulfate for Torsades de Pointes in Children with Long QT Syndrome

  title={Optimal Administration Dosage of Magnesium Sulfate for Torsades de Pointes in Children with Long QT Syndrome},
  author={Kenji Hoshino and Kiyoshi Ogawa and Takashi Hishitani and Takeshi Isobe and Yoshikatsu Eto},
  journal={Journal of the American College of Nutrition},
  pages={497S - 500S}
Background: Intravenous administration of magnesium sulphate (MgSO4) is a very effective and safe treatment for torsades de pointes (TdP) associated with acquired long QT syndrome (LQTS) in adults. Discussed here is the efficacy of MgSO4 for TdP in children with congenital and acquired LQTS. Methods: The optimal MgSO4 dosage and serum magnesium (SMg) was determined in six consecutive children with TdP; four had congenital LQTS and two had acquired LQTS. A bolus injection of MgSO4 was given… 
Magnesium Treatment in Pediatric Patients.
  • Sarah Anderson, E. Farrington
  • Medicine
    Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners
  • 2021
Pharmacological treatment of acquired QT prolongation and torsades de pointes.
Some episodes of TdP could be avoided by careful prescribing of QT prolonging drugs, including an individualized assessment of risks and benefits before use, performing baseline and periodic electrocardiograms and measurement of electrolytes, especially during acute illnesses, using the lowest effective dose for the shortest possible time and avoiding potential drug interactions.
Anaesthetics and the rate corrected interval: learning from droperidol?
  • E. Shipton
  • Medicine, Biology
    Current opinion in anaesthesiology
  • 2005
Droperidol can lead to serious cardiac arrhythmias from QT prolongation and the optimal treatment of the long QT syndrome is presented along with a glimpse into future possibilities in this field.
Magnesium in man: implications for health and disease.
An extensive and comprehensive overview of Mg(2+) research over the last few decades is provided, focusing on the regulation of M g(2+) homeostasis in the intestine, kidney, and bone and disturbances which may result in hypomagnesemia.
Treating arrhythmias with adjunctive magnesium: identifying future research directions
  • W. Baker
  • Biology, Medicine
    European heart journal. Cardiovascular pharmacotherapy
  • 2017
A number of limitations and gaps to the literature exist, including an unclear link between correction of intracellular magnesium concentrations and both mechanistic and clinical outcomes, small sample sizes, varying routes of administration and doses, as well as short follow-up periods are highlighted.
Pediatric Cardiac Intensive Care Society 2014 Consensus Statement: Pharmacotherapies in Cardiac Critical Care Antiarrhythmics
  • B. Moffett, J. Salvin, Jeffrey J. Kim
  • Medicine
    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
  • 2016
This review will highlight particular arrhythmias in the pediatric critical care population and discuss salient points of pharmacotherapy of these arrhythmic patients and the mechanisms of action for the various agents, potential adverse events, place in therapy, and evidence for their use are summarized.
Successful Implantation of an Intracardiac Defibrillator in an Infant With Long QT Syndrome and Isolated Noncompaction of the Ventricular Myocardium
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Macrolide and fluoroquinolone mediated cardiac arrhythmias: clinical considerations and comprehensive review
Clinicians should be cautious when prescribing macrolide and fluoroquinolone medications to patients with risk factors that may lead to antibiotic-induced cardiac arrhythmia, including a slow heart rate and those that are taking medications to treat arrhythmias.
Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity
Information is provided on the pharmacology and the toxic effects of pharmacologic agents that are used to treat opioid use disorder, including buprenorphine, clonidine, kratom, loperamide, and methadone, with additional information provided on lofexidine, akuamma seeds, kava, and gabapentin.
hERG - Deficient Human Embryonic Stem Cell - Derived Cardiomyocytes for Modelling QT Prolongation
An hERG-deficient human CM model is generated that exhibited QT prolongation, irregular rhythm and sensitivity to other ion channel blockers and serves as an important tool that can aid in understanding the fundamental impact of hERG dysfunction, elucidate the genotype–phenotype relationship of herg deficiency and facilitate drug development.


Magnesium sulfate therapy for sustained monomorphic ventricular tachycardia.
Recording of monophasic action potentials of the right ventricle in long QT syndromes complicated by severe ventricular arrhythmias.
Humps may be interpreted as delayed repolarization phenomena probably due to a decrease in potassium conductance of some ventricular cells which may lead to focal re-excitation as a result of partial membrane depolarization.
Afterdepolarizations as a mechanism for the long QT syndrome: electrophysiologic studies of a case.
Both electrical and mechanical records are useful in considering the relative duration of systole and diastole, and it will be seen that almost exactly similar figures are obtained by calculation from the formula systoles = K Vcycle.
New whole blood analyzers and their impact on cardiac and critical care.
  • G. Kost
  • Medicine
    Critical reviews in clinical laboratory sciences
  • 1993
The hybrid laboratory (a composite of conventional clinical laboratory and patient-focused testing), performance maps, and quality paths facilitate implementation of new whole blood analyzers for optimal support of cardiac and critical care, and improved patient outcomes.
Treatment of torsade de pointes with magnesium sulfate
Zipes DP: Depressant effect of magnesium on early after depolarizations and triggered activity induced by caesium, quinidine and 4-aminopyridine in canine cardiac Purkinje fibres
  • Am Heart J 118:458–466,
  • 1989
An analysis of the time-relation of electrocardiograms
  • Heart 7:353–370,
  • 1920
A child case of torsade de pointes in patient with long QT syndrome: Only magnesium sulphate was effective
  • Acta Cardiol Paed Jpn 8:317–322,
  • 1992