What Is This Rhythm?

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The rhythm is torsades de pointes. You can recognize torsades de pointes by the changes in amplitude (large-small-large). Torsades de pointes is a polymorphic ventricular tachycardia that is a progressive, sinusoidal, cyclic alteration of the QRS axis—it means “twisting of the points.”

What is the first line intravenous treatment?

Intravenous magnesium sulfate is considered the first line agent for torsades de pointes. It is given in a dose of 1-2 grams. In cardiac arrest, the magnesium sulfate is given as a bolus. If there is a pulse present, the magnesium sulfate is administered over 5 to 60 minutes.

To learn more, check out our Education Center topic: Commonly Used Medications in ACLS

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