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Prolonged ventricular repolarisation creates early after-depolarisations, producing a characteristic polymorphic ventricular tachycardia that may degenerate into VF.
A patient may have syncope, palpitations, seizures or collapse; risk increases with hypokalaemia, hypomagnesaemia, bradycardia and QT-prolonging medicines.
Call the resuscitation team and manage pulseless or haemodynamically unstable rhythms through the current RCUK algorithm. For polymorphic VT with long QT, urgent IV magnesium and removal of triggers require the local resuscitation pathway and senior expertise.
Obtain 12-lead ECG when possible, check potassium/magnesium/calcium and review all medicines and possible congenital long-QT history.
Do not use amiodarone reflexively for prolonged-QT polymorphic VT; it can worsen QT prolongation. Persistent/recurrent episodes may require specialist pacing strategies.
UK reference: RCUK 2025 adult tachyarrhythmia algorithm. Focused editorial source check, 7 November 2026; this is not independent clinical or pharmacy sign-off. Verify current local policy, BNF/BNFC and specialist advice before treatment. Not a prescribing protocol.
Related guides: Drug-related QT prolongation โ ๏ธ ๐ซ ยท Ventricular tachycardia โ FY quick guide ๐จ ๐ซ