Ventricular tachycardia, including pulseless ventricular tachycardia or ventricular fibrillation, requires immediate resuscitation. Patients with unstable sustained ventricular tachycardia, showing signs of hypotension or reduced cardiac output, should undergo direct current cardioversion to restore sinus rhythm. If cardioversion fails, intravenous amiodarone hydrochloride is administered, followed by repeated cardioversion attempts.

Treatments

Resuscitation (for pulseless ventricular tachycardia or ventricular fibrillation)

Direct current cardioversion

Intravenous anti-arrhythmic drugs (amiodarone hydrochloride, flecainide acetate, propafenone hydrochloride, lidocaine hydrochloride)Beta-blockers (for non-sustained ventricular tachycardia)

Implantable cardioverter defibrillatorCatheter ablation (if needed)Referral to a specialist

Torsades De Pointes

Torsade de pointes is a type of ventricular tachycardia associated with a long QT syndrome. It is often drug-induced, but other factors such as hypokalemia, severe bradycardia, and genetic predisposition can also contribute.

Intravenous infusion of magnesium sulfate, which is usually effective in restoring normal heart rhythm.

Beta-blockers (excluding sotalol hydrochloride)

Atrial or ventricular pacing

It is important to avoid the use of anti-arrhythmic medications as they can further prolong the QT interval and worsen the condition.