A 60 year old man with Ischaemic Heart Disease.
Polymorphous ventricular tachycardia (Torsade de pointes).
- This is a form of VT where there is usually no difficulty in recognising its ventricular origin.
- wide QRS complexes with multiple morphologies
- changing R - R intervals
- the axis seems to twist about the isoelectric line
- it is important to recognise this pattern as there are a number of reversible causes
- heart block
- hypokalaemia or hypomagnesaemia
- drugs (e.g. tricyclic antidepressant overdose)
- congenital long QT syndromes
- other causes of long QT (e.g. IHD)
This recording has been kindly donated by Dr G. Butrous of St George's Medical School London who is a cardiologist involved in EUROTOP.