Ventricular Tachycardia (VT): Meaning, Causes, and Treatment

Introduction

Ventricular tachycardia (VT) is a type of fast heart rhythm that originates from the ventricles (the lower chambers of the heart). It can be life-threatening and requires prompt medical attention.

Definition of Ventricular Tachycardia

VT is defined as a rapid heart rate of 100 beats per minute (bpm) or more, originating from the ventricles, lasting for at least three consecutive beats. It can be categorized as: - Sustained VT: Lasting more than 30 seconds or requiring termination due to hemodynamic instability. - Non-sustained VT: Lasting less than 30 seconds and resolving spontaneously.

Causes of Ventricular Tachycardia

VT commonly occurs in people with underlying heart disease. Some major causes include: - Coronary artery disease (e.g., after a heart attack) - Cardiomyopathy (dilated or hypertrophic) - Electrolyte imbalances (low potassium or magnesium) - Myocarditis (inflammation of the heart muscle) - Congenital heart conditions (such as long QT syndrome) - Toxic causes (e.g., drug-induced QT prolongation)

Symptoms of Ventricular Tachycardia

Some patients with VT may not have symptoms, while others may experience: - Palpitations (fast, irregular heartbeat) - Dizziness or fainting - Shortness of breath - Chest pain - Cardiac arrest in severe cases

Diagnosis

A doctor may diagnose VT using: - Electrocardiogram (ECG): The primary test to identify VT. - Holter monitor: A device that records heart rhythm over 24-48 hours. - Electrophysiological study (EPS): Assesses electrical activity of the heart. - Cardiac MRI or echocardiogram: To detect underlying structural heart disease.

Treatment Options

Management depends on the severity of the condition:

Emergency Treatment

  • Cardioversion (electric shock therapy) for unstable VT.
  • Intravenous antiarrhythmic medications (e.g., amiodarone, lidocaine).

Long-Term Treatment

  • Medications: Beta-blockers, amiodarone.
  • Implantable cardioverter-defibrillator (ICD): Prevents sudden cardiac death.
  • Catheter ablation: Destroys abnormal heart tissue causing VT.
  • Lifestyle changes: Managing heart disease risk factors (e.g., blood pressure control, quitting smoking).

Conclusion

Ventricular tachycardia is a serious condition that requires proper diagnosis and treatment. If you experience symptoms such as palpitations or fainting, seek medical attention immediately.

Source recommendations

1. American Heart Association Guidelines on Ventricular Arrhythmias

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
  2. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  4. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
  5. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/ventricular-fibrillation

2. European Society of Cardiology Guidelines for the Management of 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.ahajournals.org/doi/10.1161/CIR.0000000000000549
  5. https://pubmed.ncbi.nlm.nih.gov/26320108/

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