Polymorphic ventricular tachycardia, long Q-T syndrome, and torsades de pointes

Polymorphic ventricular tachycardia is an uncommon arrhythmia with multiple causes. Classification and management are based on the QT interval. Torsades de pointes denotes polymorphic ventricular tachycardia in the setting of a prolonged QT interval and usually is iatrogenic in origin, though the congenital long QT syndrome is becoming recognized more frequently. Therapy of polymorphic ventricular tachycardia focuses on the establishment of hemodynamic stability, the removal and/or correction of precipitants,and the acute and chronic inhibition of subsequent episodes. Long-term management must be tailored to the individual and the underlying causes, and should be performed by an experienced cardiac electrophysiologist.