Ventricular tachycardia (V-tach or VT) is a cardiovascular disorder in which fast heart rate occurs in the ventricles of the heart.[3] Although a few seconds of VT may not result in permanent problems, longer periods are dangerous; and multiple episodes over a short period of time are referred to as an electrical storm.[3][6][7] Short periods may occur without symptoms, or present with lightheadedness, palpitations, shortness of breath, chest pain, and decreased level of consciousness.[2] Ventricular tachycardia may lead to coma and persistent vegetative state due to lack of blood and oxygen to the brain. Ventricular tachycardia may result in ventricular fibrillation (VF) and turn into cardiac arrest.[2][3] This conversion of the VT into VF is called the degeneration of the VT. It is found initially in about 7% of people in cardiac arrest.[2]
Ventricular tachycardia can occur due to coronary heart disease, aortic stenosis, cardiomyopathy, electrolyte imbalance, or a heart attack.[2][3] Diagnosis is by an electrocardiogram (ECG) showing a rate of greater than 120 beats per minute and at least three wide QRS complexes in a row.[2] It is classified as non-sustained versus sustained based on whether it lasts less than or more than 30 seconds.[2] The term ventricular arrhythmia refers to the group of abnormal cardiac rhythms originating from the ventricle, which includes ventricular tachycardia, ventricular fibrillation, and torsades de pointes.[2]
In those who have normal blood pressure and strong pulse, the antiarrhythmic medication procainamide may be used.[2] Otherwise, immediate cardioversion is recommended, preferably with a biphasic DC shock of 200 joules.[2] In those in cardiac arrest due to ventricular tachycardia, cardiopulmonary resuscitation (CPR) and defibrillation is recommended.[5] Biphasic defibrillation may be better than monophasic.[5] While waiting for a defibrillator, a precordial thump may be attempted (However reserved to those who have the prior experience of doing so) in those on a heart monitor who are seen going into an unstable ventricular tachycardia.[5] In those with cardiac arrest due to ventricular tachycardia, survival is about 75%.[2] An implantable cardiac defibrillator or medications such as calcium channel blockers or amiodarone may be used to prevent recurrence.[2]
^"Ventricular tachycardia: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 29 May 2019.
^ abcdefghijklmnopqrsBaldzizhar, A; Manuylova, E; Marchenko, R; Kryvalap, Y; Carey, MG (September 2016). "Ventricular Tachycardias: Characteristics and Management". Critical Care Nursing Clinics of North America. 28 (3): 317–329. doi:10.1016/j.cnc.2016.04.004. PMID 27484660.
^ abcdef"Types of Arrhythmia". NHLBI. July 1, 2011. Archived from the original on 7 June 2015. Retrieved 7 September 2016.
^B Garner, J; M Miller, J (April 2013). "Wide Complex Tachycardia - Ventricular Tachycardia or Not Ventricular Tachycardia, That Remains the Question". Arrhythmia & Electrophysiology Review. 2 (1): 23–29. doi:10.15420/aer.2013.2.1.23. PMC 4711501. PMID 26835036.
^ abcdNeumar, RW; Shuster, M; Callaway, CW; Gent, LM; Atkins, DL; Bhanji, F; Brooks, SC; de Caen, AR; Donnino, MW; Ferrer, JM; Kleinman, ME; Kronick, SL; Lavonas, EJ; Link, MS; Mancini, ME; Morrison, LJ; O'Connor, RE; Samson, RA; Schexnayder, SM; Singletary, EM; Sinz, EH; Travers, AH; Wyckoff, MH; Hazinski, MF (3 November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–367. doi:10.1161/cir.0000000000000252. PMID 26472989. In the appendix
^Eifling M, Razavi M, Massumi A. "The evaluation and management of electrical storm". Texas Heart Institute Journal 2011; 38: 111–121
^Bains, Kavin, Janfaza, David, Flaherty, Devon, et al. "Sympathetic Blockade for the Management of Refractory Ventricular Tachycardia: A Case Report". A&A Practice 2021;15(4):e01456. doi:10.1213/XAA.0000000000001456.
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