Right Ventricular Outflow Tract Ventricular Tachycardia (RVOT-VT)

Introduction

Right Ventricular Outflow Tract Ventricular Tachycardia (RVOT-VT) is a type of arrhythmia that originates from the outflow tract of the right ventricle. It is the most common form of idiopathic ventricular tachycardia, typically affecting young individuals with structurally normal hearts.

Causes and Risk Factors

RVOT-VT is usually caused by triggered activity due to delayed afterdepolarizations. The main risk factors include: - Genetic predisposition - Increased adrenergic activity (e.g., exercise or stress) - Electrolyte imbalances

Symptoms

Most patients experience: - Palpitations - Dizziness - Syncope (fainting) in severe cases - Chest discomfort (infrequent)

Diagnosis

The diagnosis of RVOT-VT is confirmed using several tests: - Electrocardiogram (ECG): Shows characteristic features of a left bundle branch block pattern and inferior axis. - Holter Monitor: Detects intermittent episodes. - Exercise Stress Test: May provoke arrhythmia. - Electrophysiological Study (EPS): Helps to confirm diagnosis and assess treatment options.

Treatment Options

  1. Pharmacological Treatment:
    • Beta-blockers
    • Calcium channel blockers (Verapamil)
  2. Catheter Ablation:
    • Radiofrequency Ablation (RFA) is a highly effective treatment.
  3. Lifestyle Modifications:
    • Avoid stimulants (e.g., caffeine, alcohol)
    • Manage stress and anxiety

Prognosis and Considerations

  • RVOT-VT is usually benign and non-life-threatening.
  • If left untreated, it can lead to persistent palpitations and reduced quality of life.
  • Patients with structural heart disease require additional assessment to rule out more serious arrhythmias.

Conclusion

RVOT-VT is a manageable condition with good treatment outcomes. If you experience frequent palpitations, consult your doctor for an appropriate evaluation.

Source recommendations

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

  1. https://pubmed.ncbi.nlm.nih.gov/29084733/
  2. https://www.sciencedirect.com/science/article/pii/S2405500X22010945
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000548
  4. https://www.jacc.org/doi/abs/10.1016/j.jacc.2017.10.054
  5. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193

2. 2022 ESC Guidelines on 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://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://www.ecrjournal.com/articles/comment-esc-guidelines-2022-management-patients-ventricular-arrhythmias-and-prevention?language_content_entity=en

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