Management of torsades de pointes is well established and unchanged: intravenous magnesium sulfate is first-line for both terminating and preventing recurrence, regardless of the baseline magnesium level, alongside immediate defibrillation for unstable episodes. The essential adjuncts are correcting electrolyte abnormalities (especially hypokalemia), withdrawing QT-prolonging drugs, and — for bradycardia- or pause-dependent torsades — temporary overdrive pacing or isoproterenol. Most antiarrhythmic drugs are avoided because they further prolong the QT interval.
Further reading: 2020 AHA advanced cardiovascular life support guidelines (Panchal et al., Circulation 2020); cardiac channelopathies review (Nehme et al., JAHA 2025).