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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.
Pulseless Ventricular Tachycardia (VT) on ECG
Introduction
Pulseless ventricular tachycardia (VT) is a life-threatening cardiac arrhythmia that requires immediate intervention. It is characterized by rapid, wide-complex tachycardia on ECG but with no detectable pulse due to ineffective cardiac output.
ECG Features of Pulseless VT
- Regular wide QRS complexes (>120 ms)
- Rate typically >150 bpm
- Absence of P waves or AV dissociation
- Monomorphic or polymorphic QRS complexes
- Extreme axis deviation in some cases
Causes of Pulseless VT
- Coronary artery disease (especially acute myocardial infarction)
- Electrolyte imbalances (e.g., hypokalemia, hyperkalemia, hypomagnesemia)
- Drug toxicity (e.g., antiarrhythmics, tricyclic antidepressants)
- Structural heart diseases (e.g., cardiomyopathy, valvular disease)
Emergency Management
Pulseless VT is treated as a form of cardiac arrest with the following steps: 1. Immediate CPR - High-quality chest compressions should be initiated immediately. 2. Defibrillation - Use of an automated external defibrillator (AED) or a manual defibrillator to deliver an immediate shock. 3. Epinephrine (1 mg every 3–5 min IV/IO) - If VT persists after defibrillation. 4. Antiarrhythmic drugs - Amiodarone (300 mg IV, followed by 150 mg if needed) or lidocaine as alternative. 5. Identify the underlying cause - Correct electrolyte imbalances and treat reversible causes.
Prognosis and Post-Resuscitation Care
Successful resuscitation should be followed by close monitoring in an intensive care unit. Further cardiologic evaluation, coronary angiography, and electrophysiological studies may be necessary.
Related Clinical Guidelines
- 2020 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
- 2022 European Resuscitation Council (ERC) Guidelines for Resuscitation
Source recommendations
1. 2020 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
- https://professional.heart.org/en/science-news/2020-aha-guidelines-for-cpr-and-ecc
- https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000918
- https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000916
2. 2022 European Resuscitation Council (ERC) Guidelines for Resuscitation
- https://cprguidelines.eu/guidelines-2021
- https://www.erc.edu/
- https://cprguidelines.eu/
- https://www.cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-Guidelines-2021-Ne.pdf
- https://pubmed.ncbi.nlm.nih.gov/33773825/
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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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