The most common cause of a lethal dysrhythmia is by a PVC hitting the peak of the T wave known as RonT Phenomenon. This causes a pulseless shockable or. Dopamine For Pulseless Electrical Activity Rhythm peaDopamine For Pulseless Electrical Activity Rhythm ImagesProtocols Emergency Medical Training Services. Ventricular Tachycardia Monomorphic and Polymorphic. Primary Assessment. Airway basic Breathing CirculationSecondary Assessment. Airway advanced. Breathing confirm by at least 2 methods. Circulation IV access. Differential search for and treat causesIf Stable continue with algorithm. If Unstable go to bottom box and provide electrical therapy. Note May go directly to cardioversionStable Polymorphic V tach. Is QT baseline interval prolonged Magnesium 1 to 2g in 2. L D5. WAmiodarone 1. IV bolus over 1. 0 minutes. Lidocaine 0. 5 to 1mgkg IV push Synchronized cardioversionStable Monomorphic V tach. Amiodarone 1. 50 mg IV bolus over 1. Lidocaine 0. 5 to 1mgkg IV push Synchronized cardioversionIf hemodynamically unstable, synchronize cardioversion at 1. J, 2. 00. J, 3. 00. J, 3. 60. J. or equivalent Biphasic energy Remember to check for a pulse after each shock. Note Once a patient has received electrical therapy all ventricular drugs should then be followed by another shock.