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

PMVT is an uncommon arrhythmia with multiple causes. Classification and management are based on the Q-T interval. Torsades de pointes denotes PMVT in the setting of a prolonged Q-T interval and usually is iatrogenic in origin, although congenital LQTS is being recognized more frequently. Therapy of PMVT focuses on the establishment of hemodynamic stability, the removal or correction of precipitants, and the acute and long-term inhibition of subsequent episodes. Evaluation of these patients should include a thorough history and physical examination and an assessment for underlying heart disease and known eliciting factors. Long-term management must be tailored to the individual and the underlying cause and should be conducted by an experienced cardiac electrophysiologist.