Ventricular tachycardia

Question 1

Sustained VT

Answer 1

Episodes lasting > 30 seconds OR long enough to cause symptoms.
Categorised into stable and unstable

Question 2

Unstable sustained VT

Answer 2

Patients condition rapidly deteriorates
Leads to haemodynamic compromise or cardiac arrest.

Question 3

Stable sustained VT

Answer 3

Patients condition remains relatively stable despite the rapid heart rhythm.
No compromise to haemodynamic status or cardiac output.

Question 4

Non-sustained VT

Answer 4

Transient episode that lasts for < 30 seconds.
Terminates spontaneously without intervention.

Question 5

Pulseless or fibrillation VT

Answer 5

1st line = Immediate defibrillation + CPR
2nd line = IV amiodarone

Question 6

Unstable sustained VT - treatment

Answer 6

1st line = direct current cardioversion.
2nd line = IV amiodarone and repeat direct current

Question 7

Stable sustained VT - treatment

Answer 7

1st line = IV anti-arrhythmic drug (amiodarone preferred)

Question 8

Non-sustained VT - treatment

Answer 8

1st line = beta-blocker

Question 9

Maintenance treatment

Answer 9

Cardioverter defibrillator implant.
Some patients also require drug treatment = sotalol, beta-blocker alone OR beta-blocker with amiodarone

Question 10

Torsade de pointes

Answer 10

Prolonged QT interval
Treatment = magnesium sulfate
Causes = sotalol and other drugs that prolong QT interval, hypokalaemia and bradycardia