Types of ventricular arrhythmia stanford health care. Premature ventricular contractions premature ventricular contractions pvcs occur commonly. The specific treatment you receive depends on what is causing the arrhythmia and the type or severity of your ventricular tachycardia. Ventricular arrhythmias are abnormal rapid heart rhythms that start in the lower chambers of the heart the ventricles. Vt is defined as a rhythm originating in the ventricles. The most common first step in diagnosing ventricular tachycardia is an electrocardiogram ecg ekg.
This type of arrhythmia may be either welltolerated or lifethreatening, requiring immediate diagnosis and treatment. Ventricular fibrillation vf, unconscious ventricular tachycardia vt, and tachycardias with haemodynamic instability. Sustained ventricular tachycardia can be induced in some symptomatic patients with transient. While monomorphic ventricular tachycardia vt is not usually due to active ischemia, polymorphic vt or ventricular fibrillation vf are often ischemiainduced arrhythmias. Ventricular tachycardia diagnosis and treatment mayo clinic. Ventricular tachycardia diagnosis and treatment mayo. Ventricular arrhythmias i ohio state medical center. While implantable cardioverterdefibrillators icds have been shown to be effective in preventing sudden death due to ventricular arrhythmias, they are not able to prevent recurrent vt episodes. The three big ventricular problems you need to be aware of and understand for the physician assistant exam pance are premature ventricular contractions pvcs, ventricular tachycardia, and ventricular fibrillation. Polymorphic ventricular tachycardia pvt is a type of ventricular tachycardia in which there are several ventricular foci with the resultant qrs complexes differing in amplitude, axis and period. Types of vt that occur in the absence of structural heart disease include right ventricular rv monomorphic extrasystoles, rv outflow tract rvot vt, left ventricular lv outflow tract lvot vt, idiopathic lv tachycardia ilvt, idiopathic propranololsensitive. The term ventricular arrhythmias incorporates a wide spectrum of abnormal cardiac rhythms, from single premature ventricular complexes to sustained monomorphic ventricular tachycardia vt, polymorphic vt, and ventricular fibrillation. It may result either from atrioventricular nodal reentrant tachycardia avnrt or from an accessory pathway, which may occur as part of the wolffparkinsonwhite wpw syndrome. Vtach can be serious, especially in people with heart disease, and may be associated with more symptoms than other types of arrhythmia.
Georges university of london, uk imperial college, london, uk cardiology update 2015 davos, switzerland. Pdf ventricular tachycardia is a malignant cardiac rhythm which frequently causes hemodynamic collapse if not treated early and. Types of ventricular tachycardia vt stanford health care. Diagnosis and management of common types of supraventricular. Although a few seconds may not result in problems, longer periods are dangerous. Diagnosis and management of common types of supraventricular tachycardia margaret r. Ventricular fibrillationpulseless ventricular tachycardia defining criteria per ecg clinical manifestations pulse disappears with onset of vf collapse, unconsciousness agonal breaths apnea in of reversible death common etiologies acute coronary syndromes leading to ischemic areas of myocardium. Conclusions in patients with ischemic cardiomyopathy and an icd who had ventricular tachycardia despite antiarrhythmic drug therapy, there was a significantly lower rate of the composite primary. Both are lifethreatening arrhythmias most commonly associated with heart attacks or scarring of the heart muscle from a previous heart attack. Ventricular tachycardia in the absence of structural heart. Symptoms may include palpitations pulsation in the neck, chest pain, lightheadedness or dizziness, and dyspnea. The word ventricular refers to your heart s lower chambers.
In the absence of hypotension, monomorphic ventricular tachycardia can be treated with intravenous sotalol 1 mgkg to a maximum of 100 mg or amiodarone 5 mgkg. Cardiac arrhythmias john a kastor,university of maryland. Ventricular fibrillationpulseless ventricular tachycardia defining criteria per ecg clinical manifestations pulse disappears with onset of vf collapse, unconsciousness agonal breaths apnea in types of supraventricular tachycardia are caused by a reentry phenomenon producing acceler ated heart rates. Accelerated rhythms can be frightening to the patient if recurrent or persistent, and can cause sig nificantmorbidity. This type of tachycardia has a site of origin near the left posterior fascicle. Ventricular tachycardia vtach or vt is a type of regular, fast heart rate that arises from improper electrical activity in the ventricles of the heart. Ventricular tachycardia symptoms and causes mayo clinic. Ventricular tachycardia and sudden cardiac death ncbi. More benign forms of idiopathic vt can also occur in the absence of structural heart disease. The rapid rhythm keeps the heart from adequately filling with blood, and less blood is able to pump through the body.
An ekg is a device used to record on graph paper the electrical activity of the. Ventricular tachycardia is a common arrhythmia in patients with structural heart disease and heart failure. Ventricular tachycardia may last for only a few seconds, or it can last for much longer. Characteristics, prognosis and treatment of the ventricular arrhythmias of right ventricular dysplasia. Pulseless ventricular tachycardia is treated using the left branch of the heart attack arrest algorithm. The predominant origin of this vt type is the right ventricular outflow tract rvot but it is also found at the left ventricular. Longterm outcomes of ventricular tachycardia ablation in different types of structural heart disease.
Ventricular arrhythmias include ventricular tachycardia and ventricular fibrillation. Tachycardia is the medical term for a fast heart rate. Electrical signals in the ventricles are fired in a very fast and uncontrolled manner, causing the heart to quiver rather than beat and pump blood. Ventricular tachycardia vt types and ecg see online here ventricular tachyarrhythmias are a group of arrhythmias that result in a heartbeat greater than 100 beats per minute and originate anywhere in the ventricle. Sometimes, ventricular tachycardia can cause your heart to stop sudden cardiac arrest, which is a lifethreatening medical emergency. Aadrefractory ventricular tachycardia vt with recurrent implantable cardioverter defibrillator icd shocks 12 patients age 65 9. Types of ventricular tachycardia vt although most patients with vt have structural heart disease, usually with prior myocardial infarction or cardiomyopathy, impairment of the heart pumping function, there are several subsets of patients without any structural heart abnormalities. There are five main types of arrhythmias, described by the speed of heart rate they cause and where they begin in the heart. Ventricular tachycardia is a fast heart rate that starts in the hearts lower chambers ventricles. Review article ventricular tachycardia in the absence of.
Under diseased conditions, different types of electrical waves can occur in the ventricles, resulting in different types of ventricular arrhythmias. Supraventricular tachycardia svt is one type of tachycardia. Idiopathic ventricular tachycardia is a generic term that refers to ventricular arrhythmias that originate in hearts without structural disease. Treatment of vt involves both emergent management and prevention. Ventricular tachycardia vt is a significant cause of morbidity and mortality in patients with structural heart disease shd. Types of arrhythmias including less common types and symptoms and diagnosis of the correct subtype. This article focuses on the most common types of paroxysmal svt. The seriousness depends largely on whether other cardiac dysfunction is present and on the degree. Paroxysmal supraventricular tachycardia psvt is another type of shortcircuit arrhythmia. It is unusual for supraventricular tachycardia to be caused by structurally abnormal hearts. Apr 07, 2020 treatment of vtach depends largely on what is causing the arrhythmia and the type or severity of your ventricular tachycardia. Dec 01, 2015 ventricular tachycardia vt is a significant cause of morbidity and mortality in patients with structural heart disease shd. Ventricular tachyarrhythmias are a group of arrhythmias that result in a heartbeat greater than 100 beats per minute and originate anywhere in the ventricle.
Disordered electrical activity causes the hearts lower chambers ventricles to quiver, or fibrillate, instead of contracting or beating normally. The two main types of ventricular tachycardia are those that resolve on their own within 30 seconds nonsustained vtach and those that last more than 30 seconds, interfere with normal blood flow or require medical. Vt prevents the ventricles from fully contracting, which means that less blood is pumped to the body. The commonest reason for pvt is myocardial ischaemia. Repetitive monomorphic vt is a relatively unusual type of vt in which short paroxysms of monomorphic tachycardia occur among periods of sinus rhythm and ven. Realised the importance of electrocardiography, and published on arrhythmias, particularly ventricular tachycardia. The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing accelerated heart rates. Ventricular fibrillation american heart association. Diagnosis is often delayed because of the misdiagnosis of anxiety. The task force for the management of patients with supraventricular tachycardia of the european society of cardiology esc. For adults, a normal resting heart rate ranges from 60 to 100 beats per minute. Jun 01, 2011 realised the importance of electrocardiography, and published on arrhythmias, particularly ventricular tachycardia. Ventricular tachycardia vtach a rapid heartbeat that originates in the ventricles.
Monomorphic ventricular tachycardia is a more organized rhythm than the polymorphic form, and patients may maintain a reasonable hemodynamic state. A study of 100 tracings compared with 70 cases of idiopathic ventricular tachycardia. Ventricular fibrillation, or vfib, is considered the most serious cardiac rhythm disturbance. Short periods may occur without symptoms, or present with lightheadedness, palpitations, or chest pain. And thats what it is in a nutshell an abnormally rapid heartbeat. Idiopathic ventricular tachycardia and ventricular fibrillation idiopathic vt is a monomorphic vt occurring in patients with no structural heart disease. Pdf definition, diagnosis and management of tachycardia. Supraventricular tachycardia svt is an abnormally fast heart rhythm arising from improper electrical activity in the upper part of the heart. Longterm outcomes of ventricular tachycardia ablation in. Sinus tachycardia is a normal increase in heart rate in response to activity running or playing, fear or excitement. Ventricular tachycardia may go away on its own within 30 seconds nonsustained vtach or last more than 30 seconds sustained vtach or vt. Munger, ventricular tachycardia in the absence of structural heart disease the interventricular septum in the region of the rvot. Ventricular tachycardia overview and treatment guide.
How to recognise and manage idiopathic ventricular tachycardia. When confronted with a tachycardia having a broad qrs complex, it is important to be able to differentiate between a supraventricular and a ventricular tachycardia. You may feel dizzy or short of breath, or have chest pain. Recognition of this type of tachycardia, has important practical value. Symptoms may include palpitations including possible pulsations in. Medication given for the treatment of a supraventricular tachycardia svt may be harmful to a patient with a ventricular tachycardia vt. Ventricular arrhythmias and the prevention of sudden cardiac death. Two apparently remote types of ventricular tachycardia from a single. The two main types of ventricular tachycardia are those that resolve on their own within 30 seconds nonsustained vtach and those that last more than 30 seconds, interfere with normal blood flow or require medical intervention to resolve sustained vtach. Guideline title nsw agency for clinical innovation. Highly trained athletes may have resting heart rates lower than 60. The management of these rhythms should be according to the australian resuscitation guidelines arc as set out below. This type of arrhythmia is a rapid, regular heartbeat more than 100 beats per minute that can last for just a few seconds or much longer.
There are three main types of ventricular tachyarrhythmias. Several discrete forms of idiopathic ventricular tachycardia have been identified, and electropharmacologic data suggest that multiple arrhythmogenic mechanisms may account for these arrhythmias. Symptoms may include palpitations, feeling faint, sweating, shortness of breath, or. Pdf the diagnosis and management of ventricular arrhythmias. Adapted with permission from colucci ra, silver mj, shubrook j.
Ventricular tachycardia vt can lead to ventricular fibrillation vfib. The qrs morphology in postmyocardial infarction ventricular tachycardia. Atrial or supraventricular tachycardia svt is a fast heart rate that starts in the upper chambers of the heart. The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing acceler ated heart rates. The term ventricular arrhythmias incorporates a wide spectrum of abnormal cardiac rhythms, from single premature ventricular complexes to sustained monomorphic ventricular tachycardia vt. This prohibits the heart from pumping blood, causing collapse and cardiac arrest. Ventricular tachycardia is a common arrhythmia in patients with structural heart disease and heart failure, and is now seen more frequently as these patients survive longer with modern therapies. Ventricular arrhythmias in the absence of structural heart. Some forms of this particular tachycardia are paroxysmal atrial tachycardia pat or paroxysmal supraventricular tachycardia psvt. The earliest recorded description of ventricular tachycardia vt is credited to sir thomas lewis in 19 09 1.
Ventricular arrhythmias and the prevention of sudden cardiac. Developed in collaboration with the association for european paediatric and congenital cardiology aepc chairperson spain. Polymorphic ventricular tachycardia vt is rare and generally occurs in patients with. Pdf the term ventricular arrhythmias incorporates a wide spectrum of abnormal cardiac rhythms.