Torsades de pointes
Also calledTdP · torsades · torsade de pointes · twisting of the points
Definition
A form of polymorphic ventricular tachycardia in which the QRS complexes change in amplitude and shape, appearing to twist around the isoelectric baseline ("twisting of the points"), although the twisting may not be seen in every lead or in short episodes. It occurs in the setting of a long QT interval, which can be congenital or acquired (for example, drug-induced), and the term is best kept for polymorphic VT with marked QT prolongation (over 500 ms). Drug-induced episodes usually begin with a short-long-short sequence of R-R cycles, and the triggering beat is thought to arise from an early afterdepolarization. The rate ranges from 160 to 240 bpm.
Clinical noteQT prolongation is the defining substrate: polymorphic VT with a normal QT interval is not called torsades de pointes.
Sources
- Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: executive summary. J Am Coll Cardiol. 2018;72(14):1677-1749. doi.org/10.1016/j.jacc.2017.10.053
- Drew BJ, Ackerman MJ, Funk M, et al. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. Circulation. 2010;121(8):1047-1060. doi.org/10.1161/CIRCULATIONAHA.109.192704
Last reviewed 2 October 2026. Every definition in the EKG Dictionary cites the guideline, consensus statement or original paper it comes from.