Ventricular Tachycardia

Question 1

Define ventricular tachycardia

What are the different types?

Answer 1

Rapid ventricular rhythm >100bpm with broad QRS complexes >0.12s

Sustained VT: lasting >30s
Non-sustained VT: for at least 3 consecutive beats lasting <30s
Polymorphic VT: QRS complexes with different morphologies

Question 2

What are the causes/risk factors of VT?

Answer 2

• Coronary artery disease
• Acute MI
• Cardiomyopathy
• Long QT syndrome
• Brugada syndrome
• Wolff-Parkinson-White syndrome
• Electrolyte abnormalities (low
K+/Mg2+)
• Drug toxicity

Question 3

What are the symptoms of VT?

Answer 3

• Lightheadedness
• Dizziness
• Syncope
• Chest pain
• SOB
• Impaired consciousness

Question 4

What are the signs of VT?

Answer 4

• Weak pulse
• Tachycardia
• Hypotension
• Stridor

Question 5

What are the investigations for VT?

Answer 5

ECG
- >100bpm
- Broad QRS complexes >0.12s
- Evidence of previous MI, Brugada syndrome, cardiomyopathy
• Bloods
- U&Es – low K+/Mg2+
- Troponin and CK-MB – MI
- Toxicology screen and serum drug levels
• Echocardiogram – structural heart disease, cardiomyopathy, RWMA (previous MI)
• Electrophysiologic studies

Question 6

What is the management of VT?

Answer 6

Pulseless VT
• Defibrillation
• ALS algorithm

Haemodynamically unstable
• DC cardioversion

Haemodynamically stable
• Amiodarone
• Lidocaine
• Treat the underlying cause!

Long-term
• Beta-blockers
• ICD

Question 7

What are the complications of VT?

Answer 7

• VF

* Sudden cardiac death