Torsades de pointes ("twisting of the points") is a form of polymorphic ventricular tachycardia characterized by a revolving QRS axis producing an undulating QRS amplitude that gives the tracing a ribbon-like appearance.

• The usual presentation is syncope or sudden cardiac arrest.
• Some patients may complain of dizziness, lightheadedness, or palpitations, particularly if they experience short bursts.
• Some patients will present with recurrent syncope.

It may be fatal without prompt cardioversion. Without treatment, recurrence is common.

Can occur at any age. Generally associated with an underlying long QT interval, which may be congenital or acquired. Other risk factors include female sex, QT-prolonging medications, metabolic disturbance (especially hypokalemia or hypomagnesemia), myocardial ischemia, and bradycardia.