Ventricular tachycardia (VT) is a form of arrhythmia or dysrhythmia. The pulse rate is higher or quicker than usual in a resting position, leading to arrhythmia. Ventricular tachycardia or VT might be one of the types of ventricular arrhythmias, but it can cause severe problems with time.
The heart is the body’s major organ, and it is made up of four different sections that collaborate to move oxygen throughout the body by means of blood circulation. The four components function in a split system in order to pump blood by contracting and relaxing.
When the electrical signal that activates the heart to beat and push blood doesn’t operate correctly, this is known as arrhythmia. Ventricular tachycardia or VT is a variety of ventricular arrhythmias. Generally, ventricular tachycardia is not something dangerous and lasts for only a couple of seconds. But in severe cases, it can have a lasting effect and cause cardiac arrest.
Ventricular tachycardia is a rapid heartbeat with a pulse rate of more than 100 beats per minute, far higher than the normal heart pulse rate. Ventricular tachycardia prevents the heart from getting sufficient blood, and without enough blood, the heart cannot provide oxygen to the rest of the body. And without oxygenated blood, a person can faint, suffer SCA or have a heart attack.
In a mild ventricular tachycardia case, this accelerated and irregular heartbeat lasts only for a few seconds. But if it continues for an extended period, it can cause intractable difficulties and even high blood pressure.
There are many types of ventricular arrhythmias depending on which part of the heart is causing them. It can originate in the upper or lower sections of the intermediate chamber, splitting the left and right halves.
Ventricular tachycardia is a heart rhythm disorder in which the lower chambers of the heart (ventricles) beat too rapidly. VT occurs as a result of an arrhythmia (irregular heartbeat). Ventricular tachycardia often causes a heart rhythm of more than 100, and in some cases, it is 120. The atrioventricular (AV) node is the point where the electrical impulse begins, and it’s referred to as “the heart’s doorbell.” The ventricular myocardium can contribute to the rhythm.
VT can occur as a result of electrical signals that move the heart muscles. If the electrical impulses are not accurate, VT occurs. The heart’s normal rhythm begins in the upper right chamber, known as the sinus node. In ventricular tachycardia, though, it starts in the lower chambers with irregular pulses.
Ventricular tachycardia is a type of arrhythmia that can cause heart attacks and if not treated it can lead to other heart conditions. VT can cause heart failure. VT is common in people with congestive heart failure, and it can be abrupt. The left ventricle encounters systolic abnormalities when ventricular tachycardia is present.
VT occurs due to irregular electronic responses, and this causes cardiac arrest as the heart doesn’t get adequate blood to pump. Both sustained VT and non-sustained VT are associated with cardiac arrest and heart failure. Ventricular tachycardia storms or multiple episodes of VT are also responsible for such heart conditions.
There is more than one explanation for why ventricular tachycardia takes place in the first place and it can also cause or lead to other heart complications.
Coronary heart disease occurs when the heart’s blood flow is interrupted or blocked by cholesterol or fats. In extreme circumstances, arteries can even have layers of fat in them. When the heart is deprived of adequate blood volume, it may begin to have irregular beats and reduced blood flow. This can cause ventricular tachycardia, which is characterized by decreased blood flow in the arteries.
This occurs when the heart’s aortic valves are narrowed down. The valve doesn’t open and close properly, which causes less blood flow. This also hinders the proper blood flow from the heart to the main aortas of the body. In this disease, aortic stenosis may have four degrees, and ventricular tachycardia can occur in severe cases.
This condition is related to the muscles of the heart. This can happen due to viral infection of the heart. Here the walls of the muscles become stretched, thick, or rigid. The muscles do not move properly, and the blood pump is not regular. Increased oxidative stress and leptin resistance may cause ventricular arrhythmias and high blood pressure, which can result in ventricular tachycardia.
These are mainly the electrolyte abnormalities associated with cardiovascular diseases, and in critical conditions, they can cause heart failure. This is due to the lack of water and the advancement of potassium, calcium, and magnesium in the body. The ions keep the heart’s electrical impulses going and, as a result of their higher quantity, create faster pulses that can lead to VT.
This is one of the most significant reasons for irregular heartbeat and cardiac diseases. Cardiac channelopathies are principally genetic abnormalities in the protein cells of the heart. The proteins in this mixture cause regular heart rhythm abnormalities and ventricular tachycardia. The ion channel functions are disrupted by genetic aberrations in this case.
Polymorphic ventricular tachycardia can lead to ventricular tachycardia. This is also a genetic disorder and can be life-threatening if not treated properly. Any sort of physical exercise or mental stress can trigger this condition.
This is a family disorder that can cause sudden heart failure and death due to chronic ventricular tachycardia at a young age. This might be a rare genetic disorder, but this is quite lethal and is a progressive condition.
MI is a life-threatening phase that can lead to sudden death. This can increase with stress, anxiety, heavy metals, alcohol consumption, etc. Here multiple heart muscles don’t get enough oxygen due to blockage of blood flow in the heart muscle. The myocardial infarction can cause irregular heartbeats throughout life and can also lead to ventricular tachycardia VT.
Structural heart disease is a collection of heart diseases like heart failure, cardiac arrest, coronary artery disease, congenital heart disease, etc. This can happen due to age, or people can be born with it. Cardiomyopathy is caused by any number of things, ranging from a mild cold to a severe illness or infection. Arrhythmias, heart valve problems, cardiac arrhythmia, poor circulation, and a variety of other issues can all result from cardiac disease.
This is a lifelong condition and happens with the polarisation of the heart. It can cause chronic ventricular tachycardia and can manifest with severe symptoms like seizures and fainting. Changes in your physical condition might trigger symptoms, but this illness is not curable.
These are the main reasons for ventricular tachycardia VT, and there are other reasons like idiopathic ventricular tachycardia. This is not a structural disease but happens suddenly. Here the nodes start to generate signals automatically. The idiopathic ventricular tachycardia is very deadly in some circumstances.
If the ventricular tachycardia symptoms last more than 30 seconds, they can become life-threatening; a patient can even die if this happens. If it’s a short-term problem, however, there are some typical indicators and symptoms.
The longer the time of VT the higher probability you will suffer one or all of the following:
A heart attack may be fatal if it is not treated promptly, so the first step should be to seek emergency care as soon as possible. The heart will grow weaker over time, making it increasingly difficult to treat.
There are mainly three types of ventricular tachycardia: monomorphic ventricular tachycardia, VF, and polymorphic ventricular tachycardia. All these types can also be divided into different kinds of VT. The classes can take place due to the age and gender differences of a person. And some due to genetic abnormalities.
The electrocardiogram or ECG can identify this. Here the ventricular activation is relatively constant, and the pattern of the ECG remains the same. The design is called monomorphic VT, and this is seen in victims with elemental heart diseases.
This disease has a rapid and straightforward beat rate with a deranged beat from the low part of the heart. There is a high risk of breakdown from the monomorphic VT, and it can also cause sudden cardiac arrest and collapse. Advanced cardiac treatment and antiarrhythmic medications have to involve while treating this disorder.
This is a part of the monomorphic VT and consists of re-entry and electrical abnormalities of the heart. Some medicines like beta-blockers can reduce the turns of this disorder. But the non-sustained VT usually arises from structural heart diseases.
Non-sustained VT doesn’t last long as the sustained VT, which is like 30 seconds; that’s why it is less dangerous. The main reason for this heart condition is structural heart disease and the previously altered heart condition.
Causes are coronary artery disease, Cardiac arrest, Aortic and mitral regurgitation, atrial fibrillation, Dilated heart.
The sustained ventricular tachycardia lasts more than 30 seconds, and the average heart rate is more than 120. This is also known as the wide complex tachycardia. This one originates from the ventricle and commonly arises from the scar of myocardial infarction.
This secures a re-entry of circuit current and is quite hard to diagnose. The mortality rate is relatively high after cardiac surgery due to this condition, as almost forty percent of people face the VT.
Causes are post-cardiac scars, structural abnormality, prior myocardial infarction, vulvar diseases.
This usually occurs in young children who have no previous medical history of heart diseases, and this doesn’t happen in older people and not even in people with structural heart diseases. This is more prominent in females and people under the age of forty-five.
This heart disease is caused by the “triggered” form and an irregular flow of ions in the heart. Emotional stress and adrenaline rush can cause this kind of VT.
Causes are the adrenaline rush, anxiety, mental stress, trauma.
This is a sudden cardiac case where it takes minutes for patients to drop dead. People facing these problems can lose their beat in a blink, and they can even get a severe cardiac arrest. The blood flow stops suddenly due to an erratic heartbeat, and irregular electrical pulses produce an uneven heartbeat. This can happen as a result of surgical procedures that implant scar tissue on the myofibril muscles.
The ventricles, in this case, quiver, and they cannot contract properly. Thus blood flow is also abrupted. This causes death within seconds as this is one of the near-fatal ventricular arrhythmias. Ventricular fibrillation causes the blood pressure to fall, leading to cardiac arrest and heart failure. Ventricular fibrillation might not occur if Ventricular tachycardia lasts less than 30 seconds.
The symptoms of VF are pretty similar to ventricular tachycardia.
Causes are certain medications, chest pain, drug abuse, physical or mental trauma, electrolyte abnormalities, congenital, sepsis.
Torsade de Pointes is a form of ventricular tachycardia with a change in the QRS pattern of heartbeats. This can happen genetically or with reduced potassium. The reduction of potassium causes repolarization, and that occurs in the myocardium. This time where the polarisation takes place is where the Polymorphic ventricular tachycardia is triggered.
With Polymorphic VT, the pulse rates gests redundant, and in some cases, they are even 150 to 250 per minute. The disease can even progress to fibrillation.
Causes are cardiac ischemia, heart conditions.
This also induces sudden death as the cardiac muscles turn to fibrous fatty fibers, mainly genetic. This is quite unusual and is often seen in young people.
This causes abnormal heartbeats and muscle diseases and which generally leads to heart failure. This is related to ventricular arrhythmias and can develop into VF, premature ventricular complexes. This is more extensive during exercise rather than a standstill position. If a family member has this condition, others should get a proper checkup.
The symptoms of this are quite similar to ventricular tachycardia.
Causes are hereditary factors and others.
There are several ways to diagnose ventricular tachycardia VT. The methods of diagnosing depend entirely on your doctor and your symptoms, of course. If you are of age or not capable of walking, the doctor will not recommend the stress test.
ECG might be the most popular way of diagnosing ventricular tachycardia. But apart from this, other forms are quite obvious. If you have multiple heart diseases, the professional will aim for something that’ll cover both prospects.
Here we are adding some of the best and commonly used methods of diagnosing VT.
ECG or EKG might be one of the most important and widely used processes in a heart disease prognosis. Even in emergency cases, the electrocardiogram is the first way that a physician will lean towards.
ECG is a painless test that detects the heart’s electric signals through small sensors and electrodes. They are attached to the patient’s arms, chest, and back, and lead wires are connected to the electrodes.
The doctors look through the patterns and signals conveyed by your heart. They record the time and strength of the heart and try to find a structure in there to match it with the network or pattern that might be causing your rapid heartbeat. And with this matching, they determine what kind of tachycardia a patient has.
There are portable monitors for you to carry; these are fastened to your chest. The doctor needs a long chart of signals to determine the problem.
There are mainly three types of ECG
This type of ECG is done while a person is in a comfortable position. The resting 12 EKG is also a kind of electrocardiogram, and this is the most standard form of measuring the electric signals of the heart. The EKG 12 measures heart signals from 12 electrodes that are placed chest, arms, and legs. With all the information, the charts are then interpreted by the doctor to pass a result.
This type of ECG is done while the patient is on the treadmill or on an exercise cycle. This is done to understand if physical exercises or activities trigger tachycardia. Here breathing and pressure is measured. This test is done on patients who just had a cardiac arrest and those with coronary artery diseases. This also determines the safe level of exercising.
This is done to measure the unpredictable symptoms of a patient. Here, the patient wears a small portable machine connected with a lead wire overnight or 24 hours. The doctor might ask you to record your heart activities in these hours. This is also known as the Holter monitor.
This is a more detailed electrocardiogram, and this takes more time and sorts out every abnormality in a heartbeat. Here the signals are generated over 20 minutes and also capture the periodic heartbeats.
CPET is done to evaluate the cardiopulmonary systems signal. This procedure is performed to measure any cardiac disease like a chronic obstructive pulmonary disease.
These kinds of monitors are used to determine abnormal heartbeats over a while. You might have to wear it for at least a few months, and it’s turned on easily with just a click. Any time you feel a rapid heartbeat, you just have to turn on the button. The doctor collects this data and makes a proper diagnosis.
This is also done to check the electrical signals and irregular heartbeat. Neutral impulses do generate healthy signals while contracting and blood flowing.
The EP test can determine the abnormality of heart muscles, but it can also determine if a particular medication is working correctly or not. Here the doctor maps the electrical impulses and sorts out how they are acting in each beat, and this helps to find the actual source of which is causing the abnormal heartbeat.
First, the doctor inserts an electrode through veins of the neck or groins. The electrodes are wired, and they travel down to the heart. Fluoroscopy is used in this process. The electrodes give electrical signals to find the place which is causing the irregular heartbeat.
The electrode measures the problems once it reaches their hearts. There can be a formation of blood coats the catheter while performing these tests. But this is not very complicated and quite useful.
This test is like the ultrasound of the heart. Here high-frequency sound waves are used to measure the pumping action of the heart. It gives pictures of the heart’s ventricles and its muscles.
Echo is done to check the abnormal heart valves and chamber of the heart. Any sort of genetic heart disorder is also be identified in this process. The transducer that is used in the echo throws an ultrasound beam on your heart. And this also records the echo of soundwaves. The monitor used here converts the echo into pictures.
Besides this, there is the transesophageal echo that’s practiced. Here a tiny transducer is supplied to the patient’s heart from his mouth, and the transducer records the echo, and here the computer prints are much more accurate than the standard one.
The stress echocardiogram is done to measure Coronary arteries diseases. They don’t provide information regarding blockage, but here the ultrasound is performed while you are taking an exercise.
This provides 3D images of the heart and is much detailed than an echo. This can be used to diagnose ventricular tachycardia, and the doctors can use it to find if the medications are working correctly or not.
Here a large number of magnetic and radioactive features are used. The magnetic field makes all the protons of the body align in their direction. Then the radioactive area is enabled, and here the protons start to accumulate against the magnetic field. The magnetic is then released, and there is some sort of changes in the molecules.
The doctors understand these changes, and they deliver their diagnosis depending on this system. MRI is usually done for the muscles where it is easy to determine the problem. Heart and brain show the best results in MRI.
CT scan is Computerized X-ray imaging where a beam of the ray is given to the patient while moving around the patient’s body. The signals or images produced in this machine are cross-sectional slices of a body part, and this image comprises a lot more information than the usual X-ray machines.
Once the machine generates enough information on a body part, it gives a 3D image. The three-dimensional picture provides a proper diagnosis on the body part and, in our case, regarding the heart.
The machine first processes 2D images, and later on, all the images are stacked to give a 3D image. The images are viewed in a 2D form, or the machine makes the 3D. Any organ, including the bones, provides a perfect cross-sectional image in a CT scan. The heart takes photos to explain why the ventricular tachycardia or any ventricular arrhythmias are taking place.
This is most famously done to find out any blockages in the arteries or in vain. Even if the patient is born with congenital heart disease, this can be determined by coronary angiography.
This test is simply a cardiac catheterization test. This test is used in the diagnosis and even treating the vessels. Here an X-ray imaging is used to monitor the vessels. A particular type of dye is used in this manner, and the X-ray machine can identify this dye.
As the dye proceeds, it gives images of the blood vessels, and the X-ray machine reads those data. The doctor can even eliminate those blockages while performing angiography.
These procedures can explain why you might have abnormal heartbeats and, therefore the tachycardia in general. It can even make your blood flow regularly by getting rid of the blockage in the arteries.
This is more of a primary level of diagnosis in the cardiac field. The X-ray machine uses a small dose of ionizing radiation to get a 2D picture of the heart.
Suppose you are facing the primary symptoms regarding ventricular tachycardia. In that case, the doctor might proceed for a general chest X-ray to determine that the predicaments you encounter are related to heart diseases. But for a further explanation, the doctor has to advance to an electrocardiogram or echocardiogram.
For most cases, doctors do electrocardiograms and MRIs to ensure that no other vessels other than the might cause the irregular heartbeat.
Once you have passed through the diagnosis process, the next step will be to treat ventricular tachycardia. Ventricular tachycardia is easy to detect except for fibrillation. This one happens suddenly, and before the doctor can run tests, the heart stops abruptly.
To avoid such situations, people should be more conscious of their family medical history and their symptoms. This will help them to understand what might be the reason for their illness and take immediate action.
Several kinds of treatments, including therapy, can define the abnormal heartbeat and arrhythmia over time. However, the first thing to keep in mind when creating tachycardia is the patient. How the patient reacts to a specific medication, how they act after cardiac surgery, and how well they can manage their treatment. All of this defines the way and success rate of the treatment.
The type of ventricular tachycardia treatment also varies according to the symptoms and diagnosis of the patient. If the patient has an especially severe heart condition, he or she must undergo several critical events that may alter his quality of life. For example, a patient might be prohibited from engaging in any arduous physical exercise after receiving a diagnosis by the physician. To restore and maintain good health, treatments must be done correctly, and patients must accept them willingly.
This treatment is done to avoid the consequences of ventricular fibrillation, and this is done on patients with ventricular tachycardia and those whose illness might proceed to VF. So this is done to avoid pulseless tachycardia in general.
Here electrical shock is used to correct the heart’s impulses, so there is a normal heart rhythm. The electrical shock ensures that the heart will return to its original site at once, and this system is not effective with pulseless electrical activity.
The electrical shock ensures that the heart returns to its depolarized state, and thus it conveys natural impulses and gives a proper blood flow. The shock is controlled, and when it repolarizes, the regular electrical pulse is asserted, and thus the abnormal heart rhythm is terminated.
But while using these methods, the physicians have to make sure that they convey enough energy to depolarize the heart. Otherwise, fibrillation will not transpire. In this treatment, 200J to 350J of electric impulses are employed.
The shock is provided by external fibrillation who is placed on the chest. This can also be performed with the implantable cardioverter-defibrillator, and ICD does the job internally. For ICD, the ventricular shock has to be higher than the tachycardia to terminate the irregular beating, and this process is like overdriving the ventricle, to begin with.
The cardioversion procedure is a lot like the defibrillation procedure. But in this case, 100J of electric signals are used instead of 200J. This is done primarily on tachycardia with pulses. But this can also be done without using fibrillation, and medicines can be used instead.
The cardioversion procedure takes a small amount of time, and the patient can return home right after. Here electric shock is provided with electrodes placed on one’s chest. And it doesn’t need a special chamber to take place. The procedure corrects the heartbeat that’s too rapid or too irregular. But when this treatment is performed through medication, there won’t be any need for an external shock. This cardioversion is known as chemical cardioversion. And it is usually given through an IV or a pill to swallow.
The echocardiogram is often performed before the cardioversion to check for any blood clumps. Otherwise, blood clots can freely move, which might cause a fatal scene. The medication system is put through an IV to sedate the patient to make it harm-free.
Ventricular tachycardia and fibrillation are generally considered as the last resort for any form of therapy. As a result, previous surgery is also required in the case of ventricular tachycardia and fibrillation. When none of the preceding treatments work, this is what happens. For example, if blood clots are moving around in the circulation, cardioversion, and defibrillation might induce more damage than good. They can also cause a fatal reaction.
For this, physicians lean towards the surgery or the maze procedure. In this process, the surgeon makes a small cut in the heart to create scar tissue. This scar doesn’t conduct electricity nor produces any electricity. But it interferes with the erratic electricity that’s causing the tachycardia to take place. This only is assumed when no option works, and sometimes this can lead to more complications. About 40% of people survive this kind of surgery; others derive some other sort of tachycardia which is much more severe.
This one is also known as cardiac ablation, where a small catheter is pushed into the patient’s heart through veins of the groin, neck, or arm. Here electrodes are used at the end of the catheter to resolve the abnormal heart rhythms, which medicine can not resolve.
This procedure takes almost four hours, and the process is done while the patient is sedated. The electrodes help to stimulate the muscles and find the area that is causing ventricular dysfunction. Then radio-frequency is used to freeze the tissue of that part. Thus the radio-frequency energy destroys or ablest the tissues, and the problem area will not provoke any disruption again.
This type of treatment is not painful, but some might feel discomfort after the procedure. But the process is quite intricate, so you might need to find yourself a very experienced physician for this.
ICD is an implantable cardioverter-defibrillator, and this records and monitors irregular heartbeat and corrects them if needed. It can even resist significant problems like cardiac arrest, even when you are not close to getting any help. This is not embedded in almost every tachycardia patient, but for people who have QT syndrome or have heart diseases through hereditary factors, the doctors recommend the implantable cardioverter-defibrillator (ICD).
ICD is implemented when one has a quite erratic and uncertain heartbeat and cannot be controlled through medication. Ventricular tachycardia and fibrillation both cases might need an ICD, and people with weak muscles also might need ICD. If you think about antiarrhythmics versus implantable defibrillators(ICD), the ICD works for serious cases where medication works for patients with a moderate case of abnormal heart rhythm.
There are two kinds of machines. The traditional one works like a Pacemaker, and its wires are attached to the heart, and the primary device relies on the chest to produce electrical pulses. The s-ICD is different as it’s larger and has one electrode instead of wires. This one is situated under the armpit.
The drugs used in this area are antiarrhythmic medications. And most of the valuable drugs are beta-blockers which help to stabilize the irregular impulses of the heart. These medicines can even suppress the effects of acute ventricular tachycardia and fibrillation.
Procainamide is a drug that leaves up to different heart diseases, including ventricular tachycardia, specially pulseless tachycardia, and atrial flutter. This medication wraps the sodium channels, so the repolarization of the impulses happens quickly. This also reduces the probability of the reverse electrical pulse and increases the velocity of the pulse. It also resolved the myocardial infarction.
Lidocaine cures ventricular tachycardia as well as previous myocardial infarction. And the latter influences the former this is a perfect drug to avoid post-MI complications. This stabilizes multiple systoles that are extra due to irregular electric pulse. With cardioversion, it evens out the plasma level.
Amiodarone can not be used for a long time as it has a good half-life, and it starts working in just thirty minutes. As such, this is only used when the patient is stable and can handle the dosage. It can be used in the case of cardiac arrest as well.
Metoprolol is used to suppress premature irregular heartbeat and is a beta-blocker medicine. It can reduce ventricular tachycardia by the rate of almost ninety percent, and this also diminishes the physical activity-based premature beats.
Esmolol is a short-term beta-blocker used in emergency cases and can be used in several therapy sessions to contain ventricular tachycardia and fibrillation, along with other heart diseases.
Propranolol is one step ahead of metoprolol as it decreases the rate of tachycardia almost by two times. This can also reduce the level of ICD secretion, and the arrhythmia levels are similarly suppressed by using this drug. This is much more reliable and practical. Moreover, this gives a better performance when used with ICD patients.
Managing the disease itself can be quite a challenge, so here we are listing some facts related to the management of ventricular tachycardia.
The primary and vital point of ventricular tachycardia is avoiding sudden cardiac death from ventricular tachycardia. Fibrillation is what causes sudden death, and the fibrillation begins from the myocardial scratch from the operation. And that happens to people with structural heart diseases.
The abrupt changes are most often seen in a patient within an hour, and they are due to changes in clinical state. Mayo clinic-one of America’s most important heart research foundations stated very interesting data regarding this. It has been reported that extreme exercise can cause VT. However, when it comes to fatalities, they are not nearly as common as the various diseases that follow after.
And to avoid such a state, patients are treated for any kind of disease they have, including other coronary disorders like myocardial infarction and left ventricular ejection fraction. Magnetic resonance imaging is a way to identify patients who are at risk of sudden death.
Doctors can perform defibrillation and catheter ablation in general patients. People at risk are often identified and have an implantable cardioverter-defibrillator (ICD) to avoid the risk of death.
Ventricular tachycardia is a heart disease that can be congenital, or it can be developed over time due to other reasons. The illness itself is often gradual and unless it adapts to ventricular fibrillation, which can be life-threatening. The fibrillation takes only minutes to stop the heart.
There are even therapies that help the patients to recover and rehabilitate with their everyday life. Patients with ventricular tachycardia can do whatever it is they enjoy in their healthy life. Otherwise, the illness can prove to be quite pressing. Regular checkups and antiarrhythmic drug therapy will regulate the pulsation and sometimes can cure them as well. Patients who have suffered V-tach can still live a very full life.
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