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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 (PVT) and ECG Findings
Introduction
Polymorphic Ventricular Tachycardia (PVT) is a life-threatening arrhythmia characterized by rapid, irregular electrical activity in the ventricles. It often presents with a changing QRS morphology on an electrocardiogram (ECG).
Causes of PVT
PVT can be triggered by various cardiac and non-cardiac conditions, including: - Electrolyte imbalances: Low potassium (hypokalemia) or magnesium (hypomagnesemia) - Ischemic heart disease: Myocardial infarction or coronary artery disease - Long QT syndrome: Congenital or acquired (due to medications) - Catecholaminergic polymorphic ventricular tachycardia (CPVT): Genetic disorder leading to adrenergically induced arrhythmias
ECG Findings in PVT
- Rapid ventricular rate: Typically > 200 bpm
- Irregular QRS complex morphology: The shape of the QRS complexes changes beat-to-beat
- Torsades de Pointes (TdP) subtype: A subtype of PVT associated with prolonged QT intervals, showing a twisting QRS pattern around the isoelectric line
Management Approach
Immediate Treatment:
- Defibrillation: If the patient is unstable or pulseless, immediate electrical cardioversion or defibrillation is required.
- Magnesium Sulfate: First-line therapy for Torsades de Pointes, given as an intravenous infusion.
- Correction of underlying causes: Ensure proper electrolyte levels and discontinue QT-prolonging medications.
Long-Term Prevention:
- Beta-blockers: Used in CPVT to prevent adrenergic-induced arrhythmias.
- Implantable Cardioverter-Defibrillator (ICD): Recommended in cases of recurrent PVT or high-risk conditions.
- Genetic testing: Considered in cases of suspected inherited arrhythmia syndromes.
Conclusion
Polymorphic ventricular tachycardia is a serious condition requiring prompt identification and intervention. Recognizing ECG patterns and associated risk factors can help prevent life-threatening occurrences.
Source recommendations
1. American Heart Association (AHA) Guidelines on Ventricular Arrhythmias and Sudden Cardiac Death
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
- https://pubmed.ncbi.nlm.nih.gov/29097320/
- https://www.sciencedirect.com/science/article/pii/S2405500X22010945
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000548
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/ventricular-fibrillation
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://academic.oup.com/eurheartj/article/36/41/2793/2293363
- 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.
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