Ventricular Tachycardia

What Is Ventricular Tachycardia?

Ventricular tachycardia (also called V-tach or VT) is a type of abnormal heart rhythm (arrhythmia) that starts in the lower chambers of the heart and causes the heart to beat faster than normal. A healthy adult heart beats about 60 to 100 times a minute when at rest. In ventricular tachycardia, the heart beats 100 or more beats a minute.

Ventricular Tachycardia Symptoms

When someone’s heart goes into ventricular tachycardia, it may not deliver enough oxygenated blood to the rest of the body. Therefore, symptoms of ventricular tachycardia are related to lack of oxygen to the body’s organs and may include:

• Chest pain (angina)
• Dizziness
• Pounding heartbeat
• Shortness of breath
• Lightheadedness

Ventricular tachycardia can be a medical emergency even when symptoms are minor or mild. The condition is classified according to the duration of the episode:

• Nonsustained V-tach: Resolves on its own within 30 seconds. Brief episodes may not cause symptoms.
• Sustained V-tach: Lasts longer than 30 seconds. This type can cause serious health problems. Symptoms of sustained V-tach can include:
  • Fainting
  • Loss of consciousness
  • Cardiac arrest or sudden death

Ventricular Tachycardia Causes

Sometimes the cause of ventricular tachycardia is unknown. Most often, other heart problems are the cause, including:

• Coronary artery disease
• Heart failure
• Myocarditis
• Enlarged heart (cardiomyopathy)
• Heart valve disease
• Heart surgery
• Previous heart attack (myocardial infarction) or heart surgery leaves scar tissue on your heart
• Sarcoidosis
• Certain inherited conditions

Other ventricular tachycardia causes include:

• Certain medications
• Imbalance of electrolytes
• Too much alcohol or caffeine
• Recreational drugs
• Exercise

Ventricular Tachycardia Diagnosis

To diagnose ventricular tachycardia, a healthcare provider will talk with you about your symptoms, perform a physical exam, check your medical history and order tests. The most common test for diagnosing ventricular tachycardia is an electrocardiogram (ECG/EKG), which records your heart’s electrical activity.

Other tests your doctor may order include:

• Event recorder: Typically worn for about 30 days, this device records heart activity only at certain times for a few minutes at a time. You push a button when you feel symptoms. In addition, some event recorders automatically record when they detect an irregular heartbeat.
• Electrophysiological (EP) study: Your doctor guides one or more flexible tubes (catheters) through a blood vessel, usually in the groin, to different areas of the heart. Sensors at the catheter tips record the heart's electrical signals and can reveal where incorrect heart signals begin in the heart.
• Exercise stress test: You walk on a treadmill or pedal a stationary bike while your heart activity is monitored. This test shows how the heart reacts to exercise. Sometimes an echocardiogram is done as part of the test.
• Blood tests: Can check for an overactive thyroid, an electrolyte imbalance or other issues that may lead to ventricular tachycardia.

Ventricular Tachycardia Treatment

Sustained V-tach requires emergency medical treatment, as it may lead to sudden cardiac death. The goals of ventricular tachycardia treatment are to:

• Slow the rapid heartbeat.
• Prevent future episodes of a fast heartbeat.

Ventricular tachycardia treatment can include medicines, procedures and devices to control or reset the heart rhythm, and heart surgery. When another medical condition is the cause of your ventricular tachycardia, your healthcare provider will likely focus on treating that underlying problem.

Medications

Medicines such as beta blockers are often prescribed to slow the fast heartrate. Some people may need to be on more than one medication to treat their ventricular tachycardia.

Surgery & Other Procedures

Surgeries that can help control or prevent episodes of ventricular tachycardia include:

• Catheter ablation: In this treatment, your doctor inserts one or more thin tubes (catheters) into a blood vessel and guides them to the heart. Sensors on the tip of the catheter send electrical signals and record the heart's electrical activity. The doctor then uses the catheter to apply heat (radiofrequency ablation) or extreme cold (cryoablation) to create tiny scars in the heart to block irregular electrical that disrupt the heart rhythm.
• Open heart surgery: Some people with ventricular tachycardia require open heart surgery to destroy the extra heart signaling pathway that causes the fast heartbeat. Surgery is usually done only after other treatments fail or when surgery is needed to address another heart condition.
• Cardioversion: In this procedure, quick, low-energy shocks are delivered to the chest with paddles or patches to restore a regular heart rhythm. Cardioversion is generally used when emergency care is required.

Implantable Devices

Some ventricular tachycardia patients need a implantable device to help reset the heart rhythm and control the heartbeat. These devices include:

• Implantable cardioverter defibrillator (ICD): When your heart needs it, an ICD can deliver a shock to restore its regular heart rhythm.
• Pacemaker: Implanted under the skin near the collarbone through a minor surgery, a pacemaker releases electrical impulses to stimulate the heart when needed to maintain a regular heartbeat.