Ventricular Tachycardia

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Original Editor - User:Justin Bryan
Top Contributors - Justin Bryan, Lucinda hampton and Kirenga Bamurange Liliane

Introduction

Ventricular tachycardia (V-Tach) is a type of cardiac arrhythmia where the ventricle beats at 100 or more beats per minute for 3 or more consecutive beats. Unlike more general tachycardia, in V-Tach the increased beat rate originates from the ventricle itself, and note from the upper part of the heart. At rates greater that 100 bpm, the pumping ability of the heart is severely degraded, resulting in significant risk for severe symptoms and even cardiac arrest. V-Tach is considered a life-threatening cardiac arrhythmia.

Types of Ventricular Tachycardia

• Sustained V-Tach - tachycardia lasting longer than 30 seconds

• Non-sustained V-Tach - tachycardia lasting less than 30 seconds; non-sustained V-Tach does no effect the hearts ability to pump to the same degree as sustained V-Tach, symptoms are often more limited and have far less impact on the heart's ability to function

Causes and Risk Factors

A number of factors can increase the risk of developing V-Tach. Generally, these factors are associated with the pre-existance of cardiac conditions such as acute coronary syndrome or ischemic heart disease. A broad range of cardiomyopathies, including hypertrophic cardiomyopathy, infiltrative cardiomyopathy, and arrhythmogenic right ventricular cardiomyopathy have also been found to be associated with V-Tach. Certain congenital heart defects also carry risk. Other circumstances such as electrolyte imbalances and illicit drug use also increases risk. In the presence of factors such as these, V-Tach can be triggers by situations where the heart is put under certain stresses such as myocardial ischemia, sepsis, or metabolic acidosis.

Certain ion channel pathologies (channelopothies), or defects in the ability of cell membranes to allow the passage of ions involved in normal function, also carry an increased risk for V-Tach:

• Long QT syndrome
• Brugada syndrome
• Catecholaminergic polymorphic ventricular tachycardia
• Short QT syndrome
• Malignant early repolarization syndrome

V-Tach can also be idiopathic, and in this form is considered benign. Treatment usually involved prescription of calcium channel blockers, and outcomes are generally very positive.

Clinical Presentation

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Diagnostic Procedures

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Outcome Measures

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Management / Interventions

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Differential Diagnosis

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Resources

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