Which treatment is the preferred choice for torsades de pointes?

Torsades de pointes is a specific type of polymorphic ventricular tachycardia that is commonly associated with prolonged QT intervals. The preferred treatment for this condition is magnesium sulfate. This choice is substantiated by the fact that magnesium plays a critical role in stabilizing the cardiac membrane and can help correct the underlying electrolyte imbalance that contributes to torsades de pointes. Administering magnesium sulfate has been shown to effectively terminate this arrhythmia, especially in cases related to hypomagnesemia or medication-induced QT prolongation.

External pacing and defibrillation are not typically first-line treatments for torsades de pointes. External pacing might be considered in certain scenarios related to bradycardia but does not address the underlying mechanism of torsades. Defibrillation is primarily used for the management of life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia, rather than for torsades de pointes unless the patient is in a critical situation where immediate intervention is necessary.

Lidocaine, an antiarrhythmic medication, is generally used for ventricular arrhythmias but is not specifically effective for torsades de pointes. In fact, the use of lidocaine in this setting may not be indicated,