Ventricular Tachycardia

Question 1

How long does sustained ventricular tachycardia last?

Answer 1

> 30 secs

Question 2

Give 3 presentations associated with sustained ventricular tachycardia:

Answer 2

1) pre-syncope
2) syncope hypotension
3) cardiac arrest

Question 3

Give the bpm range of ventricular tachycardia:

Answer 3

120-220bpm

Question 4

How do QRS complexes present in ventricular tachycardia?

Answer 4

very broad (often >0.14)

Question 5

Who does ventricular tachycardia typically occur in?

Answer 5

Sustained ventricular tachycardia usually occurs in people with a structural heart disorder such as a heart attack, heart failure, or a cardiomyopathy. It is more common among older people. However, rarely, ventricular tachycardia develops in young people who do not have a structural heart disorder. Such young people may have a heart disorder called long QT syndrome, which can be inherited or caused by certain drugs. It can also be due to other rare inherited disorders such as the Brugada syndrome (a cardiac channelopathy).

Question 6

Why is sustain ventricular tachycardia dangerous?

Answer 6

Sustained ventricular tachycardia can be dangerous because the ventricles cannot fill adequately or pump blood normally. Blood pressure tends to fall, and heart failure follows. Sustained ventricular tachycardia is also dangerous because it can turn into ventricular fibrillation—a form of cardiac arrest. Sometimes ventricular tachycardia causes few symptoms, even at rates of up to 200 beats per minute, but it may still be extremely dangerous.

Question 7

What are the symptoms of VT?

Answer 7

1. Palpitations
2. Weakness
3. Light headedness
4. Chest discomfort

Question 8

What is the immediate treatment of VT?

Answer 8

immediate cardioversion

Question 9

What treatment is used for haemodynamically compromised VT patients?

Answer 9

emergency DC cardioversion

Question 10

How does VT present on an ECG?

Answer 10

QRS complex are broad and T waves difficult to identify

Question 11

What are the 2 main types of VT?

Answer 11

1. monomorphic VT
2. polymorphic VT

Question 12

What is monomorphic VT caused by?

Answer 12

most commonly caused by myocardial infarction

Question 13

What drug therapy is used in VT?

Answer 13

amiodarone: ideally administered through a central line
lidocaine: use with caution in severe left ventricular impairment
procainamide

Question 14

What drug should not be used in VT?

Answer 14

Veraparil

Question 15

What is the management if drug therapy fails?

Answer 15

electrophysiological study (EPS)
implant able cardioverter-defibrillator (ICD) - this is particularly indicated in patients with significantly impaired LV function