About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Polymorphic Ventricular Tachycardia Treatment
Introduction
Polymorphic ventricular tachycardia (PVT) is a life-threatening arrhythmia that originates in the ventricles and is characterized by varying QRS morphology. It is often associated with conditions such as long QT syndrome (torsades de pointes) or ischemic heart disease.
Causes and Risk Factors
- Long QT syndrome (congenital or acquired)
- Electrolyte imbalances (low potassium, magnesium, or calcium)
- Ischemic heart disease (myocardial infarction)
- Drug-induced QT prolongation (antiarrhythmics, psychotropic drugs, antibiotics)
- Brugada syndrome or Catecholaminergic polymorphic ventricular tachycardia (CPVT)
Treatment Strategies
Emergency Management
- If the patient is unstable (unconscious, no pulse):
- Immediate defibrillation (high-energy shock)
- CPR if necessary
- If the patient is stable:
- Identify and correct underlying causes
- Monitor closely for deterioration
Torsades de Pointes (TdP) – Special Case
- First-line treatment: IV magnesium sulfate (even if magnesium levels are normal)
- Stop QT-prolonging drugs
- Correct electrolyte imbalances (potassium replacement if low)
- Overdrive pacing or isoproterenol infusion (if bradycardia-induced TdP)
Prevention of Recurrence
- For congenital Long QT syndrome:
- Beta-blockers (especially for LQT1 and LQT2)
- Implantable cardioverter-defibrillator (ICD) for high-risk patients
- For ischemic heart disease-related PVT:
- Revascularization (PCI or CABG if needed)
- Beta-blockers and antiarrhythmic drugs (carefully chosen)
- For CPVT:
- Beta-blockers, avoiding catecholamine triggers
- Consider ICD implantation in high-risk cases
Conclusion
Polymorphic VT is a serious arrhythmia requiring rapid assessment and tailored treatment based on the underlying cause. Prompt intervention with defibrillation, electrolyte correction, and medications can be life-saving.
Source recommendations
1. American Heart Association (AHA) Guidelines for Ventricular Arrhythmias
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
- https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/ventricular-fibrillation
- https://www.sciencedirect.com/science/article/pii/S2405500X22010945
2. European Society of Cardiology (ESC) Guidelines on Ventricular Arrhythmias and Sudden Cardiac Death
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
- https://academic.oup.com/eurheartj/article/43/40/3997/6675633
- https://pubmed.ncbi.nlm.nih.gov/36017572/
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/09/02/14/23/2022-ESC-Guidelines-for-VAs-ESC-2022
- https://pubmed.ncbi.nlm.nih.gov/26320108/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
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Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.