Understanding Ventricular Tachycardia (VT)

Introduction

Ventricular tachycardia (VT) is a serious heart rhythm disorder that originates in the ventricles, the lower chambers of the heart. It is characterized by a rapid heart rate (typically over 100 beats per minute) that may lead to inadequate blood circulation and, in severe cases, cardiac arrest.

Causes of Ventricular Tachycardia

VT commonly occurs in individuals with underlying heart disease, including: - Coronary artery disease (CAD) – Reduced blood supply to the heart due to narrowed arteries. - Previous heart attack (myocardial infarction) – Scar tissue from an old heart attack can disrupt electrical signals. - Cardiomyopathy – Diseases affecting the heart muscle, leading to structural changes and an increased risk of arrhythmias. - Electrolyte imbalances – Abnormal levels of potassium, magnesium, or calcium can trigger VT. - Genetic conditions – Some inherited disorders, such as Long QT syndrome or Brugada syndrome, increase the risk of life-threatening arrhythmias. - Medication side effects and drug use – Certain antiarrhythmic drugs, stimulants, or illicit substances can contribute to VT.

Symptoms of VT

Symptoms can range from mild palpitations to life-threatening complications. Common symptoms include: - Rapid or irregular heartbeat - Dizziness or lightheadedness - Shortness of breath - Chest pain - Fainting (syncope) - Sudden cardiac arrest in severe cases

Diagnosis of VT

VT is diagnosed using: - Electrocardiogram (ECG) – The primary tool to detect abnormal ventricular rhythms. - Holter monitor or event recorder – Extended monitoring to capture intermittent episodes. - Electrophysiologic study (EPS) – A specialized test to assess electrical activity in the heart.

Treatment Options for VT

Treatment depends on the severity and cause of VT. Options include: 1. Emergency Treatment (for life-threatening VT): - Cardiopulmonary resuscitation (CPR) – Required if VT leads to cardiac arrest. - Defibrillation – Immediate electrical shock to restore normal rhythm in unstable VT.

2. Medications:

   • Antiarrhythmic drugs such as amiodarone, lidocaine, or beta-blockers to control heart rhythm.
   • Electrolyte replacement (e.g., potassium and magnesium) if deficiencies are present.

3. Long-Term Management:

   • Implantable cardioverter-defibrillator (ICD) – A device placed in the chest to detect and correct VT.
   • Catheter ablation – A procedure that targets and destroys the abnormal heart tissue causing VT.
   • Lifestyle modifications – Managing underlying conditions, avoiding triggers, and following a heart-healthy lifestyle.

Conclusion

VT is a potentially life-threatening condition that requires prompt diagnosis and treatment. If you experience symptoms of VT, such as a rapid heart rate or fainting, seek immediate medical attention. Long-term management strategies, including medication, medical devices, and lifestyle changes, can help prevent recurrent episodes and improve heart health.

Source recommendations

1. 2022 AHA/ACC/HRS Guideline for the Management of Ventricular Arrhythmias

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
2. https://www.sciencedirect.com/science/article/pii/S2405500X22010945
3. https://pubmed.ncbi.nlm.nih.gov/29084733/
4. https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
5. https://www.jacc.org/doi/10.1016/j.jacc.2024.02.014

2. 2022 ESC Guidelines on Ventricular Arrhythmias and Sudden Cardiac Death

1. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
2. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
3. https://pubmed.ncbi.nlm.nih.gov/36017572/
4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/09/02/14/23/2022-ESC-Guidelines-for-VAs-ESC-2022
5. https://pubmed.ncbi.nlm.nih.gov/26320108/