Polymorphic ventricular tachycardia - Revision history

Danbot: Add verified PubMed references (PMIDs 34491774, 37558300)

2026-03-22T10:43:54Z

Add verified PubMed references (PMIDs 34491774, 37558300)

← Revisión anterior		Revisión del 10:43 22 mar 2026
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	==Background==		==Background==
	*Form of [[ventricular tachycardia]]		*Form of [[ventricular tachycardia]]<ref>Viskin S, et al. Polymorphic Ventricular Tachycardia: Terminology, Mechanism, Diagnosis, and Emergency Therapy. Circulation. 2021 Sep 7;144(10):823-839. PMID 34491774</ref>
	**Multiple ventricular foci		**Multiple ventricular foci
	**QRS complexes with varying morphology		**QRS complexes with varying morphology
	*Subtypes include:		*Subtypes include:
	**[[Torsades de pointes]]		**[[Torsades de pointes]]<ref>Bergeman AT, Wilde AAM, van der Werf C. Catecholaminergic Polymorphic Ventricular Tachycardia: A Review of Therapeutic Strategies. Card Electrophysiol Clin. 2023 Sep;15(3):293-305. PMID 37558300</ref>
	**bidirectional polymorphic [[VTach]] (as seen in [[digoxin toxicity]])		**bidirectional polymorphic [[VTach]] (as seen in [[digoxin toxicity]])

2026-03-20T21:02:30Z

Add MedicationDose entries for magnesium, isoproterenol, amiodarone, lidocaine, procainamide

@@ Línea 66: / Línea 66: @@
 *≥3 episodes within 24 hours considered [[electrical storm]]
 *May require alternate treatment (i.e. [[β-blockers]], sedation, ablation)
 ==Disposition==

2025-07-30T16:50:56Z

Evaluation

← Revisión anterior		Revisión del 16:50 30 jul 2025
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	==Evaluation==		==Evaluation==
	[[File:Torsades de Pointes (polymorphic VT).svg\|thumb\|~~Rorsades~~ de Pointes in a rhythm strip.]]		[[File:Torsades de Pointes (polymorphic VT).svg\|thumb\|Torsades de Pointes in a rhythm strip.]]
	*Evaluate for underlying causes (e.g. electrolyte imbalances, [[ACS]])		*Evaluate for underlying causes (e.g. electrolyte imbalances, [[ACS]])

2025-07-30T16:50:37Z

Evaluation

← Revisión anterior		Revisión del 16:50 30 jul 2025
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	==Evaluation==		==Evaluation==
	[[File:Torsades de Pointes (polymorphic VT).svg\|Rorsades de Pointes in a rhythm strip.]]		[[File:Torsades de Pointes (polymorphic VT).svg\|thumb\|Rorsades de Pointes in a rhythm strip.]]
	*Evaluate for underlying causes (e.g. electrolyte imbalances, [[ACS]])		*Evaluate for underlying causes (e.g. electrolyte imbalances, [[ACS]])

2025-07-30T16:50:19Z

Evaluation

← Revisión anterior		Revisión del 16:50 30 jul 2025
Línea 26:		Línea 26:

	==Evaluation==		==Evaluation==
			[[File:Torsades de Pointes (polymorphic VT).svg\|Rorsades de Pointes in a rhythm strip.]]
	*Evaluate for underlying causes (e.g. electrolyte imbalances, [[ACS]])		*Evaluate for underlying causes (e.g. electrolyte imbalances, [[ACS]])

2022-08-18T07:18:29Z

Stable

← Revisión anterior		Revisión del 07:18 18 ago 2022
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	**[[Isoproterenol]], 2-8 mcg/min (if available)		**[[Isoproterenol]], 2-8 mcg/min (if available)
	**[[Overdrive Pacing]] to goal HR 90-120		**[[Overdrive Pacing]] to goal HR 90-120
	**Consider Lidocaine and avoid Amiodarone
	***Note that this is only effective for preventing recurrence of TdP - it will not convert TdP to sinus rhythm		***Note that this is only effective for preventing recurrence of TdP - it will not convert TdP to sinus rhythm
			**Consider Lidocaine
	**Avoid procainamide, amiodarone (may further prolong QT)		**Avoid procainamide, amiodarone (may further prolong QT)
	*Non-Torsades (baseline QT interval not prolonged)		*Non-Torsades (baseline QT interval not prolonged)

2022-08-18T07:16:09Z

Stable

← Revisión anterior		Revisión del 07:16 18 ago 2022
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	***1-2gm IV, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) drip		***1-2gm IV, repeat in 5-15min; then 1-2gm/hr (3-10mg/min) drip
	***Peds: 25-50mg/kg (max 2g) IV		***Peds: 25-50mg/kg (max 2g) IV
	**[[Sotalol]] (100mg IV over 5 minutes)		**[[Isoproterenol]], 2-8 mcg/min (if available)
	**[[Isoproterenol]], 2-8 mcg/min
	**[[Overdrive Pacing]] to goal HR 90-120		**[[Overdrive Pacing]] to goal HR 90-120
			**Consider Lidocaine and avoid Amiodarone
	***Note that this is only effective for preventing recurrence of TdP - it will not convert TdP to sinus rhythm		***Note that this is only effective for preventing recurrence of TdP - it will not convert TdP to sinus rhythm
	**Avoid procainamide, amiodarone (may further prolong QT)		**Avoid procainamide, amiodarone (may further prolong QT)

2019-09-25T17:02:04Z

Clinical Features

← Revisión anterior		Revisión del 17:02 25 sep 2019
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	*[[Syncope]]		*[[Syncope]]
	*[[Palpitations]]		*[[Palpitations]]
	*Altered level of consciousness		*[[Altered level of consciousness]]
	*May present with [[cardiac arrest]]		*May present with [[cardiac arrest]]

2019-08-21T18:47:44Z

Stable

← Revisión anterior		Revisión del 18:47 21 ago 2019
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	***Max dose 17mg/kg '''OR''' widening of QRS >50%		***Max dose 17mg/kg '''OR''' widening of QRS >50%
	**[[Lidocaine]], 1-1.5mg/kg IV q5min, repeat PRN up to 300mg/hr		**[[Lidocaine]], 1-1.5mg/kg IV q5min, repeat PRN up to 300mg/hr
	**~~beta~~-blockers if blood pressure tolerates~~, metoprolol 5mg IV q5 minutes to total of 15mg~~		**[[Beta-blockers]] (e.g. [[metoprolol]] 5mg IV q5m x 3) if blood pressure tolerates

	===Refractory===		===Refractory===

2019-08-21T03:11:50Z

Stable

← Revisión anterior		Revisión del 03:11 21 ago 2019
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	***Note that this is only effective for preventing recurrence of TdP - it will not convert TdP to sinus rhythm		***Note that this is only effective for preventing recurrence of TdP - it will not convert TdP to sinus rhythm
	**Avoid procainamide, amiodarone (may further prolong QT)		**Avoid procainamide, amiodarone (may further prolong QT)
	*Non-Torsades		*Non-Torsades (baseline QT interval not prolonged)
	**[[Amiodarone]], agent of choice in setting of AMI or LV dysfunction		**[[Amiodarone]], agent of choice in setting of AMI or LV dysfunction
	***150 mg over 10min (15 mg/min), followed by 1 mg/min drip over 6hrs (360 mg total), then 0.5 mg/min drip over next 18 hrs (540 mg total)		***150 mg over 10min (15 mg/min), followed by 1 mg/min drip over 6hrs (360 mg total), then 0.5 mg/min drip over next 18 hrs (540 mg total)
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	***Max dose 17mg/kg '''OR''' widening of QRS >50%		***Max dose 17mg/kg '''OR''' widening of QRS >50%
	**[[Lidocaine]], 1-1.5mg/kg IV q5min, repeat PRN up to 300mg/hr		**[[Lidocaine]], 1-1.5mg/kg IV q5min, repeat PRN up to 300mg/hr
			**beta-blockers if blood pressure tolerates, metoprolol 5mg IV q5 minutes to total of 15mg

	===Refractory===		===Refractory===