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Definition:

Ventricular tachycardia (VT) is a rapid heartbeat that starts in the ventricles.



Alternative Names:

Wide-complex tachycardia; V tach; Tachycardia - ventricular



Causes, incidence, and risk factors:

Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row.

The condition can develop as an early or late complication of a heart attack . It may also occur in patients with:

Ventricular tachycardia can occur without heart disease.

Scar tissue may form in the muscle of the ventricles days, months, or years after a heart attack. This can lead to ventricular tachycardia.

Ventricular tachycardia can also be caused by:

  • Anti-arrhythmic medications
  • Changes in blood chemistry (such as a low potassium level)
  • Changes in pH (acid-base)
  • Lack of enough oxygen

"Torsade de pointes" is a form of ventricular tachycardia that is often due to congenital heart disease or the use of certain medications.



Symptoms:

If the heart rate during a ventricular tachycardia episode is very fast or lasts longer than a few seconds, there may be symptoms such as:

Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms.



Signs and tests:

Signs include:

Ventricular tachycardia may be seen on:

Blood chemistries and other tests may be done.



Treatment:

Treatment depends on the symptoms, and the type of heart disorder. Some people may not need treatment.

If ventricular tachycardia becomes an emergency situation, it may require:

  • CPR
  • Electrical defibrillation or cardioversion (electric shock)
  • Anti-arrhythmic medications (such as lidocaine, procainamide, sotalol, or amiodarone) given through a vein

Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as procainamide, amiodarone, or sotalol). However, anti-arrhythmic medications may have severe side effects. Their use is decreasing in favor of other treatments.

Some ventricular tachycardias may be treated with an ablation procedure. Radiofrequency catheter ablation can cure certain tachycardias.

A preferred treatment for many chronic (long-term) ventricular tachycardias consists of implanting a device called implantable cardioverter defibrillator (ICD). The ICD is usually implanted in the chest, like a pacemaker. It is connected to the heart with wires.

The doctor programs the ICD to sense when ventricular tachycardia is occurring, and to administer a shock to stop it. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia. You may need to take anti-arrhythmic drugs to prevent repeated firing of the ICD.



Expectations (prognosis):

The outcome depends on the heart condition and symptoms.



Complications:

Ventricular tachycardia may not cause symptoms in some people. However, it may be lethal in other people. It is a major cause of sudden cardiac death.



Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have a rapid, irregular pulse, faint, or have chest pain . All of these may be signs of ventricular tachycardia.



Prevention:

In some cases, the disorder is not preventable. In other cases, it can be prevented by treating heart diseases and correcting blood chemistries.



References:

Olgin JE, Zipes DP. Specific Arrhythmias: Diagnosis and Treatment. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 35.




Review Date: 5/15/2008
Reviewed By: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Phone: (603) 742-5252
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