Torsades de Pointe is best described as which rhythm?

• A. Sinus Tachycardia
• B. Ventricular Tachycardia
• C. Torsades de Pointe
• D. Atrial Fibrillation with Rapid Ventricular Response

Answer: (C)

Torsades de pointes is a polymorphic ventricular tachycardia. On the ECG it shows a twisting, pendulum-like pattern of the QRS complexes that appear to rotate around the baseline. This distinctive morphology occurs because the QRS axis and amplitude continuously change from beat to beat. It most often arises when the QT interval is prolonged, which can be caused by electrolyte disturbances or certain medications, and it can deteriorate into life-threatening ventricular fibrillation if not treated promptly.

This is different from sinus tachycardia, which has normal P waves and a regular rhythm with a fast rate; from monomorphic ventricular tachycardia, which shows a wide, uniform QRS morphology; and from atrial fibrillation with rapid ventricular response, which is irregular and lacks discrete P waves. So the best description is that torsades de pointes is a form of ventricular tachycardia characterized by a twisting, polymorphic QRS pattern.