Ventricular Tachycardia (VT) is a type of arrhythmia characterized by a fast heart rate originating from the ventricles, the lower chambers of the heart. It occurs when abnormal electrical signals disrupt the heart's normal rhythm, leading to rapid and irregular heartbeats. VT can be sustained (lasting more than 30 seconds) or nonsustained (lasting less than 30 seconds). It often arises from structural heart disease or scar tissue from a previous heart attack, which creates a substrate for abnormal electrical impulses.
Clinical Evaluation
Patient History: Review of symptoms, medical history, and risk factors such as heart disease, previous heart attacks, or family history of arrhythmias.
Physical Examination: Assessment for signs of abnormal heart rhythms, such as irregular pulse, palpitations, or signs of heart failure.
Diagnostic Tests
Electrocardiogram (ECG or EKG): The primary test used to diagnose ventricular tachycardia, which shows rapid, wide QRS complexes.
Holter Monitor: A portable ECG device worn for 24 to 48 hours to record heart rhythms and detect transient episodes of VT.
Echocardiogram: Ultrasound imaging of the heart to evaluate heart structure and function, identifying underlying heart disease.
Electrophysiology Study (EPS): Invasive procedure to study the heart's electrical system, identifying the location and mechanism of VT.
Rapid heartbeat (typically above 100 beats per minute in sustained VT).
Palpitations (sensation of skipped beats or irregular heartbeat).
Dizziness or lightheadedness.
Shortness of breath.
Chest pain or discomfort.
Loss of consciousness (in severe cases).
Fatigue or weakness.
Sudden cardiac arrest (rare, but possible).
Treatment for ventricular tachycardia aims to restore normal heart rhythm, prevent recurrence, and manage underlying heart disease.
Emergency Cardioversion: Electrical shock delivered to the heart to restore normal rhythm in unstable patients.
Antiarrhythmic Medications: Drugs such as amiodarone, lidocaine, or beta-blockers to control heart rate and rhythm.
Implantable Cardioverter-Defibrillator (ICD): Device implanted under the skin to monitor heart rhythm and deliver shocks to terminate VT or treat sudden cardiac arrest.
Catheter Ablation: Minimally invasive procedure to destroy abnormal heart tissue responsible for VT, using radiofrequency energy or cryoablation.
Cardiac Rehabilitation: Program including lifestyle changes, exercise, and education to improve heart health and reduce risk factors.
Management of Underlying Conditions: Treating or managing heart disease, electrolyte imbalances, or other factors contributing to VT.
Monitoring and Follow-Up: Regular follow-up with a cardiologist to adjust medications, monitor device function (if applicable), and assess overall heart health.