Ventricular tachycardia

Question 1

What is ventricular tachycardia?

Answer 1

Potentially life-threatening arrhythmia originating in the cardiac ventricles

Question 2

What are the causes of ventricular tachycardia?

Answer 2

(Cardiac scars) Surgery, infarction
(Drugs) Antiarrhythmics, Class Ia (e.g., quinidine, disopyramide), Class III (e.g., sotalol, amiodarone), Antibiotics (e.g., macrolides, fluoroquinolones), Antidepressants (most tricyclic and tetracyclic antidepressants, lithium), Antipsychotics (e.g., haloperidol), Anticonvulsants (fosphenytoin, felbamate)
(Electrolyte imbalances) hypokalemia, hypomagnesemia, hypocalcemia

Question 3

What are the clinical features of ventricular tachycardia?

Answer 3

often asymptomatic 
(Common symotoms) Palpitations
Hypotension
Syncope
(Severe symptoms) Chest pain/pressure, cardiogenic shock, Loss of consciousness, Progression to ventricular fibrillation, Sudden cardiac death

Question 4

How is ventricular tachycardia diagnosed?

Answer 4

(ECG) 3 or more consecutive premature ventricular beats (i.e., widened QRS), Heart rate > 120 bpm

Question 5

What is the treatment for ventricular tachycardia?

Answer 5

(Initial) hemodynamically unstable with pulse → cardioversion
hemodynamically unstable without pulse → defibrillation
hemodynamically stable → Drug therapy
amiodarone, lidocaine, procainamide
(Long term) Intra-cardiac device, arrhythmic, catheter ablation