With Torsades de Pointes, the QRS complexes are polymorphic with progressive changes in height, width, shape, and axis. A characteristic finding of torsades de pointes is a recurring reversal of waveform polarity. The gradual alteration in polarity gives the appearance of QRS complexes twisting around the baseline in a spindle-like fashion. Torsades de pointes is associated with QTc prolongation. Other common etiologies include electrolyte disturbances (e.g., hypokalemia, hypocalcemia, hypomagnesemia) and medication side effects (e.g., quinidine, amiodarone). The rapid and gradual alteration of QRS complexes can be mistaken for ventricular fibrillation. Ventricular fibrillation, however, is completely chaotic without any discernible pattern or similarity between adjacent waveforms.
0:00 Intro
0:11 Polymorphic Ventricular Tachycardia
0:19 Recurring reversal of waveform polarity
0:38 Example 1
1:01 Example 2
1:19 Recap
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