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

Introduction

Ventricular tachycardia (VT) is a life-threatening arrhythmia characterized by a rapid heartbeat originating from the ventricles. It can lead to severe complications, including sudden cardiac arrest, if not managed properly.

Causes and Risk Factors

  • Structural Heart Disease: Myocardial infarction, cardiomyopathy.
  • Electrolyte Imbalance: Low potassium or magnesium levels.
  • Genetic Syndromes: Long QT syndrome, Brugada syndrome.
  • Medications: Some antiarrhythmic drugs, antidepressants.
  • Previous Heart Surgery: Scar tissue can trigger VT.

Symptoms

  • Palpitations (rapid, strong heartbeats)
  • Dizziness or fainting
  • Chest discomfort
  • Shortness of breath
  • Sudden cardiac arrest (in severe cases)

Diagnosis

  • Electrocardiogram (ECG): Identifies VT patterns.
  • Holter Monitoring: Records heart activity over time.
  • Echocardiography: Evaluates heart structure.
  • Electrophysiological Study (EPS): Identifies specific arrhythmia mechanisms.

Treatment

Immediate Management:

  • Cardioversion: Electrical shock to restore normal rhythm.
  • Antiarrhythmic Drugs: Amiodarone, lidocaine.
  • Magnesium Infusion: For torsades de pointes (a type of VT).

Long-term Treatment:

  • Implantable Cardioverter Defibrillator (ICD): Prevents sudden cardiac death.
  • Catheter Ablation: Destroys abnormal electrical pathways.
  • Medications: Beta-blockers, amiodarone.
  • Lifestyle Modifications: Avoid caffeine, stress, excessive alcohol.

Prognosis

The outcome depends on the underlying cause. Patients with ICDs have a significantly reduced risk of sudden cardiac death. Managing risk factors and regular follow-ups with a cardiologist are crucial.

Source recommendations

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

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  2. https://www.sciencedirect.com/science/article/pii/S2405500X22010945
  3. https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000549
  4. https://pubmed.ncbi.nlm.nih.gov/29084733/
  5. https://www.jacc.org/doi/10.1016/j.jacc.2024.02.014

2. 2022 ESC Guidelines on Cardiac Arrhythmias and Ventricular Tachycardia

  1. https://pubmed.ncbi.nlm.nih.gov/36017572/
  2. https://academic.oup.com/eurheartj/article/43/40/3997/6675633
  3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Ventricular-Arrhythmias-and-the-Prevention-of-Sudden-Cardiac-Death
  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.jacc.org/doi/10.1016/j.jacep.2022.12.008

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