Ventricular Tachycardia

What is ventricular tachycardia?

Ventricular tachycardia is a heart rate higher than 120 beats per minute that starts in your heart’s two lower chambers (ventricles), rather than from the normal electrical pathway.

A normal resting heart rate is 60 to 100 beats per minute.

During an episode of ventricular tachycardia, your heart is beating so fast that:

• Your blood pressure drops.
• Your heart can’t pump enough oxygen to every part of your body.
• You start to have symptoms.

Is ventricular tachycardia serious?

Yes, it is serious and requires urgent treatment. If ventricular tachycardia lasts more than 30 seconds (called sustained ventricular tachycardia), it can lead to ventricular fibrillation and sudden cardiac death.

Ventricular tachycardia vs. ventricular fibrillation

Both are abnormal heart rhythms, but ventricular fibrillation is more severe. With ventricular tachycardia, fast heartbeats keep your heart from sending enough blood to your tissues and cells.

When your heart muscles are fibrillating (twitching), they aren’t pumping blood to your body at all. This causes sudden cardiac death.

Can ventricular tachycardia go away?

Yes, it can go away in some cases. It can last just a few seconds before your heart rhythm goes back to normal.

Ventricular tachycardia risk factors

You’re more likely to have this condition if you:

• Have a history of heart disease.
• Have a family history of heart rhythm issues.
• Have coronary artery disease.
• Have myocarditis.
• Have heart failure.
• Have an enlarged heart (cardiomyopathy).
• Have heart valve disease.
• Had a heart attack (myocardial infarction) or heart surgery.
• Have severe electrolyte abnormalities.
• Use stimulant drugs such as cocaine or methamphetamines.

How does ventricular tachycardia affect my body?

When you have ventricular tachycardia, less blood than normal goes to your cells and tissues. This is because your fast heartbeats don’t allow enough time for your heart chambers to fill up before the next beat. It’s like a bus that stops so briefly at a bus stop that it leaves people behind because there isn’t time for everyone to board.

What are the symptoms?

Seek emergency help immediately to avoid the risk of cardiac arrest and death if you have these symptoms of a potentially fatal ventricular tachycardia:

• Chest pain.
• Difficulty breathing.
• Palpitations/rapid pulse.
• Dizziness, lightheadedness, or passing out.

What causes ventricular tachycardia?

When you have abnormal electrical signals in your ventricles (lower chambers of your heart), they get in the way of normal signals from your sinoatrial node that usually controls your heart rate. This creates a heart rate so fast that your heart’s chambers don’t have enough time to fill between beats.

Most people with ventricular tachycardia have another heart problem that caused it, such as:

• Coronary artery disease.
• Heart failure.
• Myocarditis.
• Enlarged heart (cardiomyopathy).
• Heart valve disease.
• Heart surgery.
• Previous heart attack (myocardial infarction) or heart surgery that made scar tissue on your heart.
• Sarcoidosis.
• Certain inherited conditions.

Ventricular tachycardia causes unrelated to your heart include:

• Medications.
• Imbalance in electrolytes (the minerals that control heart rhythm).
• Too much caffeine or alcohol.
• Recreational drugs.
• Exercise.

Sometimes the cause is unknown.

What is the most common cause of ventricular tachycardia?

Ischemic heart disease is the most common cause. This is also known as coronary heart disease or coronary artery disease. It means your heart muscle can’t get enough blood and oxygen because of blockages in the coronary arteries. This usually happens because of atherosclerosis.

How is ventricular tachycardia diagnosed?

To diagnose ventricular tachycardia, your healthcare provider will:

• Talk with you about your symptoms.
• Perform a physical exam that includes checking your pulse.
• Collect your medical history.
• Order tests.

What tests will be done to diagnose ventricular tachycardia?

An electrocardiogram (ECG/EKG), which records your heart’s electrical activity, is the most common test for diagnosing ventricular tachycardia.

Other tests may include:

• Holter monitor.
• Electrophysiology study.
• Cardiac event monitor.
• Treadmill stress test.
• Echocardiogram.
• Blood tests.

How is ventricular tachycardia treated?

You need treatment for ventricular tachycardia when you have symptoms or when you have it for more than 30 seconds (with or without symptoms).

Treatment for ventricular tachycardia involves managing any disease that causes the condition. These treatments may improve the abnormal heart rhythm or prevent it from returning.

In emergency situations, treatments for ventricular tachycardia may include:

• CPR (cardiopulmonary resuscitation).
• Electrical defibrillation.
• IV medications.

Nonemergency treatment for ventricular tachycardia usually includes:

• Radiofrequency catheter ablation (RCA): After pinpointing where an abnormal rhythm starts, your healthcare provider will use a catheter to destroy tissue in that area with an electrical current.
• Implantable cardioverter-defibrillator (ICD): This device monitors and controls your heart’s rhythm. If it detects an episode of ventricular tachycardia, it quickly sends an electrical signal to get your heart back to a normal rhythm.
• Medications: Medications can slow your heart rate and attempt to maintain a normal rhythm. Some medications are associated with serious side effects, which your doctor will review with you prior to prescription.

Complications of the treatment

Although ablation of ventricular tachycardia has a long history of safety and success, complications can sometimes happen. Complications may include:

• Damage to your heart or blood vessel.
• Blood clots.
• Bleeding.
• Infection.

How long does it take to recover from this treatment?

You can expect to stay at least one night in the hospital after ventricular tachycardia ablation. Usually, you can go back to regular activities within a few days of leaving the hospital. However, you shouldn’t do heavy physical tasks or workouts for at least three days, or as directed by your healthcare provider.

What can I expect if I have ventricular tachycardia?

Your prognosis depends on how bad your ventricular tachycardia is and whether you have an additional heart issue. The prognosis is worse if your left ventricle doesn’t work well.

Can ventricular tachycardia be cured?

It depends on the underlying cause. For some people, radiofrequency catheter ablation completely cures the abnormal rhythm, and no other treatment is needed. Implantable cardioverter defibrillators (ICDs), while not a cure, are highly effective at treating life-threatening ventricular tachycardia by delivering rapid pacing or a shock to restore normal rhythm.

How can I reduce my risk?

Avoiding the heart problems that cause ventricular tachycardia may lower your risk of getting it.

You can protect yourself from coronary artery disease, the most common cause of ventricular tachycardia, in these ways:

• Eat a low-fat, low-salt diet.
• Exercise often.
• Stay at a healthy weight.
• Stop using all tobacco products.
• Take medicines your healthcare provider prescribes for high blood pressure and high cholesterol.

How do I take care of myself?

To care for yourself with ventricular tachycardia, you can:

• Follow a heart-healthy diet and exercise plan that your healthcare team recommends for you.
• Stop using tobacco products.
• Keep taking medications your healthcare provider prescribed for you.

When should I see my healthcare provider?

It’s important to keep your appointments for regular follow-ups. Your provider will want to:

• See how you’re doing.
• Make sure your treatment is working.
• Talk about any symptoms or changes in how you feel.

When should I go to the ER?

Call 911 if you have these symptoms:

• Chest pain.
• Fainting.
• Fast and abnormal pulse.

What questions should I ask my doctor?

• How often do I need follow-up appointments?
• Do I need an ICD?
• Will I need to have catheter ablation again?