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Management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Any drugs which are known to prolong the QT interval should be stopped e.g. quinidine, disopyramide or sotalol.

Some recommend increasing the heart rate by pharmacological means (e.g. isoprenaline 2-10 microgrammes/minute) or by overdrive pacing.

Alternatively a safe and effective emergency treatment is intravenous administration of magnesium sulphate:

  • 1- 2 g of magnesium sulphate i.v. is given over 2-3 min
    • 1-2 g is equivalent to 2-4 ml (4-8 mmol) of 50% magnesium sulphate
  • a further 2 g bolus may be given if necessary
  • a continuous infusion of 2-8 mg/min is commenced
  • if this is ineffective then temporary ventricular pacing is indicated

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