Ventricular Tachycardias (VT). Information about VTDefinition. Ventricular tachycardia (VT) is a broad complex tachycardia originating from a ventricular ectopic focus. It is defined as three or more ventricular extrasystoles in succession at a rate of more than 1. Accelerated idioventricular rhythm refers to ventricular rhythms with rates of 6. Shockable rhythms (pulseless VT and VF) are seen in about half of witnessed cardiac arrests in public locations where a defibrillator has been available. Patients with underlying structural or ischaemic heart disease are more likely to have VT than SVT. ECG criteria that support SVT over VT include a right bundle branch block pattern, varying bundle branch block, an R or q. R pattern in V1, or an ectopic P wave preceding the dysrhythmia. Heart failure from other causes. Myocardial infarction. Ventricular fibrillation. Investigations. ECG. Ionised calcium levels are preferred over total serum calcium. Hypokalaemia, hypomagnesaemia, and hypocalcaemia may predispose patients either to conventional VT or torsades de pointes. Levels of therapeutic drugs - eg, digoxin. Evaluate for myocardial ischaemia: serum troponin I levels, or other cardiac markers. CXR: if there is a possibility of congestive heart failure or other cardiopulmonary pathology as contributing factors. Associated diseases. Arrhythmia may occur with or without either myocardial ischaemia or infarction. Accelerated idioventricular rhythm (sometimes termed slow ventricular tachycardia): Presents with a rate of 6. Typically occurs with underlying heart disease (ischaemic or structural). It is transient, and only rarely is associated with haemodynamic compromise or collapse. Treatment is usually not required unless there is haemodynamic impairment. Management. Address the ABCs of resuscitation and provide basic life support and advanced life support as necessary, urgent transfer to hospital, venous access, oxygen and ECG rhythm strip monitoring. See advanced life support algorithm. Replenishment of magnesium and/or other electrolytes may be a valuable adjunct to anti- arrhythmic therapies. Stable VTStable VT patients do not experience symptoms of haemodynamic decompensation. Unlike other dysrhythmias, VT tends to deteriorate into unstable states and more malignant dysrhythmias. Therefore, stable VT should be treated with lidocaine or timely cardioversion if lidocaine is ineffective. The evidence on percutaneous (non- thoracoscopic) epicardial catheter radiofrequency ablation for VT is limited but has shown that the procedure is effective in carefully selected patients and raises no major safety issues. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions. The diagnosis and management of ventricular arrhythmias. Cardiac Rhythm Management Ventricular Tachycardia Chris Pepper. QRS morphology of ventricular ectopy LBBB-inferior axis LBBB-inferior or superior axis. Ventricular tachycardia can occur without heart disease. Scar tissue may form in the muscle of the ventricles days, months, or years after a heart attack. Ventricular Tachycardia Treatment & Management. Author: Steven J Compton, MD, FACC. The ICD has changed the face of ventricular arrhythmia management. ACC/AHA/ESC Guidelines ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Evaluation and Initial Treatment of Supraventricular Tachycardia Mark S. Ventricular tachycardia (VT) may be monomorphic or polymorphic. Although commonly related to organic heart disease, a significant percentage of VTs are. In patients without established cardiac disease, the occurrence of premature ventricular complexes without sustained ventricular tachycardia is more an annoyance than.
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