Ventricular Tachycardia (ICD-10 Code: I47.2)

Introduction

Ventricular tachycardia (VT) is a life-threatening heart rhythm disorder that originates in the ventricles (the lower chambers of the heart). It is characterized by a fast heart rate—usually above 100 beats per minute—arising from abnormal electrical activity in the heart.

Causes

VT can be triggered by several conditions, including: - Coronary artery disease (CAD) – Reduced blood flow to heart muscle can lead to electrical instability. - Previous heart attack (Myocardial infarction) – Scar tissue in the heart can disrupt electrical signals. - Cardiomyopathy – Diseases of the heart muscle (dilated or hypertrophic cardiomyopathy) can predispose to VT. - Electrolyte imbalances – Abnormal levels of potassium, calcium, or magnesium can lead to arrhythmias. - Congenital heart diseases – Some genetic conditions (e.g., Brugada syndrome, Long QT syndrome) increase VT risk.

Symptoms

Symptoms of VT can range from mild to severe: - Palpitations (rapid heartbeat) - Dizziness - Shortness of breath - Chest pain - Loss of consciousness (can lead to sudden cardiac arrest if untreated)

Diagnosis

VT is diagnosed using: - Electrocardiogram (ECG) – The main tool for identifying fast ventricular rhythms. - Holter monitor – Continuous heart rhythm recording for 24-48 hours. - Electrophysiological study (EPS) – Helps identify the source of the abnormal rhythm. - Echocardiogram & MRI – Assess heart structure and function.

Treatment Options

Treatment depends on the severity and cause of VT: - Acute Management: - Stable VT – Medications like amiodarone or beta-blockers. - Unstable VT – Immediate electrical cardioversion. - Long-term Treatment: - Implantable Cardioverter Defibrillator (ICD) – A device that detects dangerous arrhythmias and shocks the heart back to normal rhythm. - Catheter Ablation – A procedure that destroys abnormal electrical pathways. - Medications – Beta-blockers, antiarrhythmic drugs (like amiodarone, sotalol). - Lifestyle Changes – Managing coronary risk factors like hypertension, diabetes, smoking, and diet.

Prevention & Prognosis

The prognosis of VT depends on its underlying cause. For individuals with structural heart disease, early detection and management with medications or ICDs can significantly improve survival rates. A heart-healthy lifestyle, including regular exercise, a balanced diet, and avoiding stimulants (e.g., caffeine, alcohol, drugs), can reduce the risk of VT recurrence.

Source recommendations

1. American Heart Association Guidelines on Ventricular Arrhythmias

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
2. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate
3. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
4. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/ventricular-fibrillation
5. https://pubmed.ncbi.nlm.nih.gov/29097320/

2. European Society of Cardiology Guidelines for Ventricular Arrhythmias and Sudden Cardiac Death

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
4. https://pubmed.ncbi.nlm.nih.gov/36017572/
5. https://www.sciencedirect.com/science/article/pii/S2405500X22010945