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Ventricular tachycardia

Contents of this page:

Alternative Names   

Wide-complex tachycardia; V tach; Tachycardia - ventricular

Definition    Return to top

Ventricular tachycardia (VT) is a rapid heartbeat that starts in the ventricles.

Causes    Return to top

Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row.

The condition can develop as an early or late complication of a heart attack. It may also occur in patients with:

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. This can lead to ventricular tachycardia.

Ventricular tachycardia can also be caused by:

"Torsade de pointes" is a form of ventricular tachycardia that is often due to congenital heart disease or the use of certain medications.

Symptoms    Return to top

If the heart rate during a ventricular tachycardia episode is very fast or lasts longer than a few seconds, there may be symptoms such as:

Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms.

Exams and Tests    Return to top

Signs include:

Ventricular tachycardia may be seen on:

Blood chemistries and other tests may be done.

Treatment    Return to top

Treatment depends on the symptoms, and the type of heart disorder. Some people may not need treatment.

If ventricular tachycardia becomes an emergency situation, it may require:

Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as procainamide, amiodarone, or sotalol). However, anti-arrhythmic medications may have severe side effects. Their use is decreasing in favor of other treatments.

Some ventricular tachycardias may be treated with an ablation procedure. Radiofrequency catheter ablation can cure certain tachycardias.

A preferred treatment for many chronic (long-term) ventricular tachycardias consists of implanting a device called implantable cardioverter defibrillator (ICD). The ICD is usually implanted in the chest, like a pacemaker. It is connected to the heart with wires.

The doctor programs the ICD to sense when ventricular tachycardia is occurring, and to administer a shock to stop it. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia. You may need to take anti-arrhythmic drugs to prevent repeated firing of the ICD.

Outlook (Prognosis)    Return to top

The outcome depends on the heart condition and symptoms.

Possible Complications    Return to top

Ventricular tachycardia may not cause symptoms in some people. However, it may be lethal in other people. It is a major cause of sudden cardiac death.

When to Contact a Medical Professional    Return to top

Go to the emergency room or call the local emergency number (such as 911) if you have a rapid, irregular pulse, faint, or have chest pain. All of these may be signs of ventricular tachycardia.

Prevention    Return to top

In some cases, the disorder is not preventable. In other cases, it can be prevented by treating heart diseases and correcting blood chemistries.

References    Return to top

Olgin JE, Zipes DP. Specific Arrhythmias: Diagnosis and Treatment. In: Libby P, Bonow RO, Mann DL, Zipes DP. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 35.

Update Date: 5/15/2008

Updated by: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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