Student learning toolCreated by: Champsedine Arevalo, MAN, RN, EMT
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Ventricular

Polymorphic VT / Torsades de Pointes

Twisting-axis polymorphic VT, often associated with prolonged QT.

Shockable
LEAD II · 25 mm/sTorsades

Characteristics

Rate
200–250 bpm
QRS
Wide, changing amplitude and axis

Common causes

  • Long QT (congenital or drug-induced)
  • Hypomagnesemia
  • Hypokalemia
  • Ischemia

ACLS treatment

  1. 1Pulseless → defibrillate (unsynchronized).
  2. 2Magnesium sulfate 1–2 g IV over 15 min for torsades.
  3. 3Correct electrolytes, stop offending drugs, overdrive pacing.

Related algorithms

Adult Cardiac Arrest →