Ventricular Tachycardia

Dr. Ayush PandeyMBBS,PG Diploma

January 14, 2019

March 06, 2020

Ventricular Tachycardia
Ventricular Tachycardia

What is ventricular tachycardia?

Ventricular tachycardia (VT) is a fast heart rhythm (more than 100 beats per minute, along with a minimum of 3 irregular heartbeats in a row), which begins in the lower chambers of the heart (ventricles). Worsening VT, if left untreated, leads to life-threatening conditions such as ventricular fibrillation and may lead to death.

What are its main signs and symptoms?

Symptoms of VT may start or stop abruptly. In some cases, no symptoms may be seen. The most common symptoms of VT observed during an episode include:

  • Shortness of breath
  • Chest discomfort also called angina
  • Palpitations (where irregular or rapid heartbeats are felt, making the individual uncomfortable)
  • Weak or no pulse
  • Low blood pressure
  • Light-headedness
  • Dizziness
  • Fainting (syncope)

What are the main causes?

The various factors or conditions leading to VT include:

  • Early or late complication of a heart attack
  • Congenital heart defect

Inherited heart rhythm problems which include:

  • Long QT syndrome
  • Brugada syndrome
  • Myocarditis
  • Cardiomyopathy
  • Hypertrophic
  • Dilated
  • Heart failure
  • Heart surgery
  • Valvular heart disease
  • Scar tissue in the muscle of the ventricles (generally, after a heart attack)

Other non-cardiac causes of VT include:

Medications which include:

  • Anti-arrhythmic drugs (used to treat an abnormal heart rhythm)
  • Non-prescription decongestants
  • Herbal remedies and diet pills
  • Cocaine or other stimulants
  • Changes in blood chemistry which include:
  • Low potassium level
  • Changes in acid-base balance
  • Lack of oxygen

How is it diagnosed?

The physician will take a complete history of symptoms, carry out a thorough physical examination and check the pulse and blood pressure. The physician may further advise the following tests:

  • Blood tests which include blood chemistry, pH of blood and oxygen level in blood
  • Chest X-ray
  • Electrocardiogram (ECG) or Holter monitor (where 24-48 hour monitoring of heartbeat is required)
  • Intracardiac electrophysiology study (EPS)
  • Loop recorder or device to record rhythm

Management for VT depends on the type of heart disorder and the symptoms seen and includes:

Medications given through a vein during an episode or orally as long-term treatment include:

  • Lidocaine
  • Procainamide
  • Sotalol
  • Amiodarone

Treatment measures during an episode including:

  • Cardiopulmonary resuscitation (CPR)
  • Cardioversion (electric shock)
  • Ablation: In which the heart tissue causing the abnormal heartbeat is destroyed.
  • An implantable cardioverter defibrillator (ICD): An implanted device that detects any rapid heartbeat which is life-threatening and quickly signals the heart to change the rhythm back to normal by sending an electrical shock.


  1. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Ventricular tachycardia
  2. Bruce A. Koplan, William G. Stevenson. Ventricular Tachycardia and Sudden Cardiac Death . Mayo Clin Proc. 2009 Mar; 84(3): 289–297. PMID: 19252119
  3. American College of Cardiology. Ventricular Tachycardia Washington [Internet]
  4. healthdirect Australia. Tachycardia. Australian government: Department of Health
  5. Michael Spartalis et al. Novel approaches for the treatment of ventricular tachycardia. World J Cardiol. 2018 Jul 26; 10(7): 52–59. PMID: 30079151
  6. Foth C, Alvey H. Rhythm, Ventricular Tachycardia (VT, V Tach). [Updated 2018 Dec 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
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