Ventricular Tachycardia

Question 1

Define ventricular tachycardia.

Answer 1

In ventricular tachycardia (V-tach or VT), abnormal electrical signals in the ventricles cause the heart to beat faster than normal, usually 100 or more beats per minute, out of sync with the upper chambers.

Question 2

Explain the aetiology/risk factors of ventricular tachycardia.

Answer 2

Lack of oxygen to the heart due to tissue damage from heart disease
Abnormal electrical pathways in the heart present at birth (congenital heart conditions, including long QT syndrome)
Cardiomyopathy
Medication side effects
An inflammatory disease affecting skin or other tissues (sarcoidosis)
Abuse of recreational drugs, such as cocaine
Imbalance of electrolytes, mineral-related substances necessary for conducting electrical impulses

Question 3

Summarise the epidemiology of ventricular tachycardia.

Answer 3

The prevalence of VT was 16% in men and 15% in women with CAD, 9% in men and 8% in women with hypertension, valvular disease, or cardiomyopathy without CAD, and 3% in men and 2% in women with no cardiovascular disease.

Question 4

Recognise the presenting symptoms of ventricular tachycardia. Recognise the signs of ventricular tachycardia on physical examination.

Answer 4

Dizziness
Shortness of breath
Lightheadedness
Palpitations
Angina
Seizures

Sustained or more serious episodes of ventricular tachycardia may cause:
Loss of consciousness or fainting
Cardiac arrest (sudden death)

Question 5

Identify appropriate investigations for ventricular tachycardia and interpret the results.

Answer 5

ECG
Electrolytes
Troponin I
CK-MB
Investigations to consider
Transthoracic echocardiogram

Question 6

Generate a management plan for ventricular tachycardia.

Answer 6

1. Antiarrhythmic medications + treatment of reversible cause (if present)
2. Synchronised cardioversion ± antiarrhythmic medications

Question 7

Identify the possible complications of ventricular tachycardia and its management.

Answer 7

Complications of ventricular tachycardia vary in severity depending on such factors as the rate, and duration of a rapid heart rate, the frequency with which it happens, and the existence of other heart conditions. Possible complications include:

• Inability of the heart to pump enough blood (heart failure)
• Frequent fainting spells or unconsciousness
• Sudden death caused by cardiac arrest

Question 8

Summarise the prognosis for patients with ventricular tachycardia.

Answer 8

Idiopathic VT generally carries a favourable prognosis. In most patients, idiopathic VT is not a progressive condition.