What Treatments are Available?
The goals of treating ventricular tachycardia are to manage any underlying disease, which may improve or eliminate the abnormal heart rhythm, and prevent future episodes.
In an emergency, the immediate goal is to slow the heart rate to normal. This may involve CPR, electrical defibrillation or giving IV medications.
Most patients with ventricular tachycardia have two treatment options — radiofrequency catheter ablation (RCA) and an implantable cardioverter defibrillator (ICD). Both treatment options are associated with good outcomes when they are performed at a medical center where the doctors are highly experienced in treating patients with ventricular tachycardia.
Radiofrequency Catheter Ablation
Radiofrequency catheter ablation (RCA) is a procedure performed by a cardiac electrophysiologist, which is a cardiologist who focuses on the treatment of heart rhythm disorders. In the first part of the procedure, the physician uses electrophysiology techniques to pinpoint the location in the heart where the abnormal rhythm originates.
In the second step, the physician uses a catheter with a special tip on it that emits a high frequency form of electrical current. The energy is directed at the area in the ventricle where the abnormal current originates to destroy a tiny amount of tissue. This is called an ablation procedure.
Ablation of ventricular tachycardia has a long history of safety and success. For some patients, ablation completely cures the abnormal rhythm, and they require no further treatment. For other patients, ablation enhances the effectiveness of an ICD.
Implantable Cardioverter Defibrillator
An implantable cardioverter defibrillator (ICD) is a device that monitors and controls the heart’s rhythm to prevent ventricular tachycardia. It is implanted under the skin.
An ICD consists of a pulse generator, which is about the size of a pager, and one or more lead wires that connect the pulse generator with the heart. The leads are inserted through the veins and positioned in the heart. The leads transmit the heart’s electrical activity to a computer microchip in the pulse generator. If the computer detects an abnormal heartbeat, the pulse generator sends an electrical signal across the lead(s) to the heart to restore normal heart rhythm.
Clinical studies show that ICDs are effective for nearly all patients in stopping life-threatening ventricular tachycardias.
Medications to slow down the heart rate are another treatment option for patients with ventricular tachycardia. These drugs can be effective but are associated with some serious, potentially fatal side effects, and their use is declining.
The Heart's Electrical System
The atria (the heart’s upper chambers) and ventricles (the heart’s lower chambers) work together, alternately contracting and relaxing to pump blood through the heart. The electrical system of the heart is the power source that makes this possible. Here’s what happens during a normal heartbeat:
If you are under a doctor’s care for ventricular tachycardia, it is important that you keep your appointments for regular follow-up visits. Your doctor will want to monitor your condition, make sure the treatment is still effective and discuss any symptoms or other changes in your condition that may occur.
It is important for you to continue to follow a heart healthy diet and exercise plan as recommended by your healthcare team.
Ablation of Ventricular Tachycardia
Cleveland Clinic is a national referral center for patients with ventricular arrhythmias, performing more than 500 ablation procedures for this condition from 2003 through 2009.
In 2009, Cleveland Clinic physicians performed 95 ablations for ventricular tachycardia and eliminated all tachycardias in 82 percent of those patients. In another 6 percent, the procedure successfully eliminated at least one tachycardia in patients with multiple tachycardias.