Amiodarone and polymorphic ventricular tachycardia: to slow down or to accelerate the underlying rhythm?

Polymorphic ventricular tachycardia (VT) comprises a variety of different subforms. Two patients were admitted to our hospital and developed polymorphic VT under treatment with amiodarone. However, each of them turned out to have a very different form of the arrhythmia and therefore required a different therapeutic approach. The clinical decision-making required a distinction between the two forms, and the following therapeutic approach included terminating the administration of amiodarone in the first case and continuing administration in the other case. As the most common forms of polymorphic VT are described, it becomes clear that each different form should be identified because of the important therapeutic implications. In particular, the role of amiodarone can be quite different in the management of these different forms of polymorphic VT.