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Potentially life-threatening emergency
Ventricular tachycardia
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Potentially life-threatening emergency

Ventricular tachycardia

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Contributors: Ryan Hoefen MD, PhD
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Synopsis

Ventricular tachycardia : Chest pain, Dizziness, Heart palpitations, Syncope, Dyspnea, Presyncope, HR increased
A cardiac arrhythmia originating from the ventricles. May be asymptomatic or may present with dizziness, palpitations, chest pain, shortness of breath, syncope, or sudden cardiac arrest. Characterized by a wide QRS complex (duration >120 msec), although supraventricular tachyarrhythmias may also exhibit a wide QRS complex when abnormal intracardiac conduction (aberrancy) is present. Distinction between these arrhythmias may be helpful for long-term treatment, although it may not be necessary for treatment of an unstable patient.

Ventricular tachycardia (VT) may be classified as:
  • Sustained or nonsustained – Sustained VT is defined as persistence for ≥30 seconds. Nonsustained VT is defined as duration of >3 beats but spontaneous termination within 30 seconds.
  • Monomorphic or polymorphic – Morphology of all QRS complexes is the same in monomorphic VT, whereas beat-to-beat variation in QRS morphology is seen in polymorphic VT.
VT is most commonly observed in patients with underlying structural cardiac abnormalities (including coronary artery disease, hypertrophic cardiomyopathy, dilated cardiomyopathy, and ion channel mutations such as Brugada syndrome and long QT syndrome), although some patients will present with idiopathic VT, which is defined by occurrence of VT in a structurally normal heart.

In patients at high risk for arrhythmia and a history of dual-chamber implanted cardioverter-defibrillator placement, exposure to higher levels of fine pollution particles (particulate matter ≤2.5 µm aerodynamic diameter; PM2.5) was associated with higher odds of ventricular arrhythmia.

Treatment varies depending on the presenting symptoms and hemodynamic stability. Options may include cardiopulmonary resuscitation, electrical defibrillation, or use of antiarrhythmic drugs (eg, amiodarone). Patients with a history of life-threatening or recurrent VT will often undergo radiofrequency catheter ablation and/or placement of an implantable cardioverter defibrillator (ICD). Subcutaneous versus transvenous placement of the ICD is under study.

Codes

ICD10CM:
I47.2 – Ventricular tachycardia

SNOMEDCT:
25569003 – Ventricular tachycardia

Differential Diagnosis & Pitfalls

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:11/05/2022
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Potentially life-threatening emergency
Ventricular tachycardia
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A medical illustration showing key findings of Ventricular tachycardia : Chest pain, Dizziness, Heart palpitations, Syncope, Dyspnea, Presyncope, HR increased

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