Ventricular tachycardia is characterized by increased heart rate arising in the ventricles. It is a life threatening condition, indicating immediate medical intervention.
In the condition of ventricular tachycardia, the heartbeat is increased causing a sudden drop in the blood pressure, resulting in inability of the heart to pump blood to other body organs. Such sequence of events gives rises to the following symptoms:
Convert to ICD-10-CM : 427.1 converts approximately to: 2015/16 ICD-10-CM I47.2 Ventricular tachycardia Approximate Synonyms Nonsustained paroxysmal ventricular tachycardia Sustained ventricular tachycardia Ventricular tachycardia Ventricular tachycardia [icd9data.com]
"Wide Complex Tachycardia - Ventricular Tachycardia or Not Ventricular Tachycardia, That Remains the Question". Arrhythmia & Electrophysiology Review. 2 (1): 23–9. doi:10.15420/aer.2013.2.1.23. PMC 4711501. [en.wikipedia.org]
KEYWORDS: Atrioventricular nodal reentry tachycardia; Bidirectional ventricular tachycardia; Bundle branch block; Electrocardiogram; Supraventricular tachycardia [ncbi.nlm.nih.gov]
Abstract A 61-year-old male patient was admitted to our hospital with recurrent palpitations and syncope. Electrocardiography, echocardiography, and contrast-enhanced computed tomography were performed. [ncbi.nlm.nih.gov]
Prior to the event, he experienced lightheadedness and palpitations. When he fainted, cardiopulmonary resuscitation was performed. Defibrillator pads were placed on the patient, which demonstrates pulseless ventricular tachycardia. [step2.medbullets.com]
but don’t loose consciousness; Not tolerated ventricular tachycardia: the patient starts to complain palpitations, extreme weakness, and then quickly loses consciousness. [af-ablation.org]
She was put on proton pump inhibitors since last 3 months by her treating physician attributing her complaints of palpitation and uneasiness to some epigastric discomfort. [casesjournal.biomedcentral.com]
- Skipped Beats
Your heartbeat quickens, and you feel as if your heart is “skipping beats.” This rhythm may cause severe shortness of breath, dizziness, or fainting (syncope). [texasheart.org]
Symptoms include a rapid pulsation, an abnormally rapid or irregular beating of the heart. Palpitations are a sensory symptom and are often described as a skipped beat, rapid fluttering in the chest, pounding sensation in the chest or neck, or a flip-flopping [en.wikipedia.org]
When reported, symptoms generally consist of palpitations—often described as pounding in the chest, fluttering, or a sensation of skipped beats—and may also include light-headedness or chest discomfort. [onlinejacc.org]
- Irregular Heart Rhythm
If left untreated, some forms of ventricular tachycardia may get worse and lead to ventricular fibrillation (fast and irregular heart rhythm), which can be life-threatening. [wakemed.org]
It arises in the heart’s lower chambers (ventricles) from tissues that generate a rapid and irregular heart rhythm. Ventricular tachycardia is a life-threatening emergency that may require an electrical shock therapy called cardioversion. [sharecare.com]
If you experience unexplained fainting, dizziness, lightheadedness, shortness of breath or palpitations, you should be evaluated for possible ventricular tachycardia. [my.clevelandclinic.org]
Types of Ventricular Tachycardia Monomorphic ventricular tachycardia Polymorphic ventricular tachycardia Torsades de pointe Symptoms Symptoms may include: Chest discomfort (angina) Fainting (syncope) Light-headedness or dizziness Palpitations Shortness [practicalclinicalskills.com]
Seek immediate medical help if you feel lightheaded or dizzy, or have chest pain or a sustained rapid heartbeat. [cedars-sinai.edu]
Seek immediate medical attention if you experience heart palpitations, chest pains, dizziness, nausea and shortness of breath. [advocatehealth.com]
[…] their careers cut short by exercise-induced ventricular tachycardia.  Symptoms [ edit ] Symptoms experienced by patients with both sustained and non-sustained ventricular tachycardia may include:   Palpitations Breathlessness Light-headedness Vertigo [en.wikibooks.org]
- Generalized Tonic-Clonic Seizure
After developing multiple generalized tonic-clonic seizures refractory to levetiracetam, fosphenytoin, and valproic acid, the decision was made to initiate lacosamide. [ncbi.nlm.nih.gov]
- The preliminary diagnosis is done using electrocardiogram that measures the electrical activity of the heart. In case when the patient is hemodynamically stable then, 12-lead ECG and electrolyte levels are first obtained. ECG would also provide appropriate information regarding the cause, which leads to development of ventricular tachycardia. This would also help differentiate between potential arrhythmias .
- Following this, appropriate laboratory studies along with echocardiography and coronary angiography are indicated. These are required for designing a suitable treatment regime.
- Chest radiography is conducted in conditions, when presenting symptoms suggest heart failure or any other cardiopulmonary pathology as the causative factor. Imaging studies such as CT scan and MRI do not provide useful information for diagnosing ventricular tachycardia.
- Left Axis Deviation
In fact, there is an important rule in LBBB shaped VT with left axis deviation that cardiac disease should be suspected and that idiopathic right ventricular VT is extremely unlikely. [heart.bmj.com]
In general, left axis deviation suggests ventricular tachycardia. QRS duration QRS duration 0.14 s suggest ventricular tachycardia. QRS duration 0.16 s strongly suggest ventricular tachycardia. [ecgwaves.com]
axis deviation with RBBB morphology- Right axis deviation with LBBB morphology QRS Characteristics in precordial leads- QRS concordance either positive or negative (spec 0.90)- Onset of R wave to nadir of S wave (RS interval) 100ms in any precordial [clinicaladvisor.com]
Fascicular VT typically occurs in otherwise healthy young adults (between the ages of 15 and 40 years), presenting as an RBBB morphology tachycardia with left-axis deviation with a relatively narrow QRS duration (usually 140 ms) (60,61). [onlinejacc.org]
- Wide QRS Complex
KEYWORDS: Algorithms; VT score; Ventricular tachycardia; Wide QRS complex tachycardia [ncbi.nlm.nih.gov]
Any wide QRS complex tachycardia (QRS 0.12 second) should be considered VT until proved otherwise. [msdmanuals.com]
Distinguishing ventricular tachycardia from supraventricular tachycardias with wide QRS complexes Occasionally supraventricular tachycardias (which mostly have normal QRS complexes, i.e QRS duration 0.12 seconds) may display wide QRS complexes. [ecgwaves.com]
Any wide QRS complex tachycardia (QRS 0.12 sec) should be considered VT until proved otherwise. [merckmanuals.com]
And you notice that on EKG you have these course wide QRS complexes. And a wide QRS complex means that the QRS complex is greater than three small boxes. [pl.khanacademy.org]
- Atrioventricular Dissociation
Atrioventricular dissociation (including fusion/capture beats and partial dissociation) was assigned two points. We recommend 3 VT score points for a firm diagnosis of VT. [ncbi.nlm.nih.gov]
Atrioventricular dissociation usually is present. This means that the sinus node is depolarizing the atria in a normal manner at a rate either equal to, or slower than, the ventricular rate. [sjo.org]
Note the presence of a premature and early narrow QRS complex (*) and atrioventricular dissociation ( ) indicative of ventricular origin. [revespcardiol.org]
Do you see atrioventricular dissociation? If AV dissociation is present, the diagnosis is VT. AV dissociation occurs when P waves, representing atrial depolarization, are seen at different rates than the QRS complexes. [healio.com]
- T Wave Alternans
In the pediatric population, although T-wave alternans do seem to be associated with serious VAs, other variables offer more information. [emedicine.com]
Prognostic utility of microvolt T-wave alternans in risk stratification of patients with ischemic cardiomyopathy. J Am Coll Cardiol. 2006May2; 47 ( 9 ):1820-1827 Epub 2006 Apr 19 [ PubMed ] 34. Nolan J, Batin PD, Andrews R, et al. [ncbi.nlm.nih.gov]
Signal-averaged ECG, baroreflex sensitivity, heart rate variability, and T-wave alternans were not helpful for arrhythmia risk stratification. [academic.oup.com]
Other noninvasive tests, such as T-wave alternans, signal-averaged ECG, and heart rate variability, do not provide diagnostic confirmation, but might be helpful in defining arrhythmia risk in patients with CAD. 17 Electrocardiographic Findings During [revespcardiol.org]
- The major goal of treatment of ventricular tachycardia is to manage any underlying disease condition. In emergency situations, patients are given cardiopulmonary resuscitation to stabilize the abnormal heart beats.
- Long term management of the condition includes administration of anti-arrhythmic medications. These however, have several side effects and should therefore be used with caution. In addition to medications, individuals are also given implantable cardioventer-defibrillator and catheter ablation . Cardiac ablation is indicated in patients with recurrent ventricular tachycardia. This method is safer when compared to anti-arrhythmic medications and can also be safely used in patients with advanced heart diseases .
- Cardioverter–defibrillator is a type of device that is implanted under the skin, for constant monitoring and controlling heart’s rhythm. It is one of the most effective treatment regimens to avoid development of life threatening complications of ventricular tachycardia.
- In many cases, combination of treatment methods for managing the condition of patients with structural heart diseases is required.
Prognosis of ventricular tachycardia depends on the functioning of left ventricles. The underlying disease conditions and severity of the symptoms also affect the prognosis. However, left ventricular functioning may not always be the determining factor for prognosis of ventricular tachycardia. Studies have shown that individuals with good left ventricular functioning, but having long QT syndrome, and hypertrophic cardiomyopathy are at an increased risk of sudden death. It has been estimated that, about 30% individuals with non-sustained ventricular tachycardia and ischemic cardiomyopathy are more likely to suffer sudden death within 2 years of onset of disease. Prognosis is excellent in individuals with idiopathic ventricular tachycardia .
Heart diseases are the most common cause of ventricular tachycardia. Individuals with cardiomyopathy, myocarditis, heart failure, or valvular heart disease are at an increased risk of developing this condition. Ventricular tachycardia often is a common accompaniment in patients, who have undergone heart surgery.
In addition to underlying heart disorders the following factors can predispose an individual to develop ventricular tachycardia:
- Electrolyte imbalances, characterized by changes in the levels of potassium, magnesium and calcium
- Lack of oxygen
- Ph changes
- Development of systemic diseases such as systemic lupus erythematosus, rheumatoid arthritis, amyloidoisis, hemochromatosis and sarcoidosis
- Inherited channelopathies, which include long and short QT syndrome, catecholaminergic polymorphic ventricular tachycardia and Brugada syndrome 
The incidence rate of ventricular tachycardia is higher in the developed nations. In developing countries, the prevalence of these diseases is relatively low. It has been estimated that, in the US, ventricular tachycardia was the major cause of sudden death in about 300,000 cases each year .
Statistics have revealed that ventricular tachycardia accounts for 5.6% of all mortality. Men are more prone to develop the disease condition, mainly because of higher incidence of ischemic heart diseases in them. Females, who have long QT syndrome, are more prone to develop ventricular tachycardia .
Under normal physiological conditions, the heart rate is effectively controlled by the electrical signals, which are transmitted across the heart muscles. Various conditions may cause the signals to be sent too rapidly, leading to development of ventricular tachycardia. Rapid heartbeats in turn lead to decreased cardiac output which results from decreased ventricular filling. In conditions of ischemic heart disease and mitral valve insufficiency, there is also significant decrease in ventricular stroke output as well as reduced hemodynamic tolerance .
Majority of the cases of ventricular tachycardia cannot be prevented. However, individuals with underlying heart diseases should get it treated in order to prevent the onset of ventricular tachycardia.
Ventricular tachycardia (VT) is a dangerous form of arrhythmia, which can call for development of debilitating complications. Individuals affected by ventricular tachycardia, have heart rate of more than 100 beats/minute, accompanied by 3 or more irregular beats. Underlying disease condition, heart diseases, myocardial infarction and heart surgery, all can cause ventricular tachycardia to develop .
- Definition: Ventricular tachycardia is a condition, characterized by rapid heartbeats, which initiates from the ventricles. In this disorder, the pulse rate of the affected individuals goes beyond 100 beats/minute.
- Cause: Patients with underlying disease conditions are at an increased risk of contracting ventricular tachycardia. Conditions such as cardiomyopathy, myocarditis, heart failure and valvular heart disease favor development of ventricular tachycardia. The condition can also occur as a complication in patients who have undergone heart surgery.
- Symptoms: Symptoms of tachycardia include discomfort in chest, light headedness, dizziness and palpitations. In many cases, individuals also experience shortness of breath and can even faint.
- Diagnosis: Conducting electrocardiogram forms the basis of diagnosis procedure. This is done to measure the electrical activity of the heart. In addition to this, certain other tests such as chest radiography and coronary angiography would also be required.
- Treatment: In emergency situations, stabilizing the heart rate and bringing it to a normal state is the primary goal of treatment. Medications, catheter ablation and cardioverter defibrillation are also indicated depending on condition of the patient.
- Turker Y, Ozaydin M, Acar G, Ozgul M, Hoscan Y, Varol E, et al. Predictors of ventricular arrhythmias in patients with mitral valve prolapse. Int J Cardiovasc Imaging. Feb 2010;26(2):139-45.
- Brugada J, Brugada R, Brugada P. Channelopathies: a new category of diseases causing sudden death.Herz. May 2007;32(3):185-91
- McNally B, Robb R, Mehta M, Vellano K, Valderrama AL, Yoon PW, et al. Out-of-hospital cardiac arrest surveillance --- Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005--December 31, 2010. MMWR Surveill Summ. Jul 29 2011;60(8):1-19
- Buxton AE. Patients with nonsustained ventricular tachycardia. In: Sudden Cardiac Death: Prevalence, Mechanisms, and Approach to Diagnosis and Management, Akhtar M, Myerburg R, Ruskin J (Eds), Williams & Wilkins, Baltimore 1994.
- Sarter BH, Finkle JK, Gerszten RE, Buxton AE. What is the risk of sudden cardiac death in patients presenting with hemodynamically stable sustained ventricular tachycardia after myocardial infarction? J Am Coll Cardiol 1996; 28:122.
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- Monserrat L, Elliott PM, Gimeno JR, et al. Non-sustained ventricular tachycardia in hypertrophic cardiomyopathy: an independent marker of sudden death risk in young patients. J Am Coll Cardiol 2003; 42:873.
- Josephson ME, Callans DJ. Using the twelve-lead electrocardiogram to localize the site of origin of ventricular tachycardia. Heart Rhythm. Apr 2005;2(4):443-6.
- Wellens HJ, Bär FW, Lie KI. The value of the electrocardiogram in the differential diagnosis of a tachycardia with a widened QRS complex. Am J Med. Jan 1978;64(1):27-33
- Sarkozy A, Tokuda M, Tedrow UB, et al. Epicardial ablation of ventricular tachycardia in ischemic heart disease. Circ Arrhythm Electrophysiol 2013; 6:1115.