Out-of-hospital pleomorphic ventricular tachycardia and resuscitation: Association with acute myocardial ischemia and infarction

Roger D. White, Douglas L. Wood

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Pleomorphic ventricular tachycardia is characterized by QRS complexes with repeated variation in polarity, amplitude, and regularity. When associated with prolongation of the QT interval, the term torsades de pointes is used to describe the arrhythmia. It usually is seen clinically in association with class IA antiarrhythmic drugs such as quinidine and procainamide, bradycardia, hypokalemia, and, much less often, other drugs and electrolyte disorders as well as a result of congenital and neurogenic causes. It also may accompany acute myocardial infarction or ischemia. We describe four patients in whom pleomorphic ventricular tachycardia was observed as the presenting rhythm or during the course of resuscitation in out-of-hospital cardiac arrest. In all four patients, acute myocardial ischemia appeared to be the provocative mechanism. Therapeutic implications include an awareness of the unusual behavior of this arrhythmia, especially its propensity to terminate spontaneously. Such awareness may prevent the delivery of unnecessary defibrillatory shocks.

Original languageEnglish (US)
Pages (from-to)1282-1287
Number of pages6
JournalAnnals of emergency medicine
Volume21
Issue number10
DOIs
StatePublished - Oct 1992

Keywords

  • pleomorphic ventricular tachycardia
  • torsades de pointes

ASJC Scopus subject areas

  • Emergency Medicine

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