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What Is Ventricular Tachycardia? Ventricular tachycardia (V-tach) is a heart rhythm disorder (arrhythmia) caused by abnormal electrical signals in ventricles. Ventricles (lower chambers of the heart) fill with blood from the atria (top chambers of the heart) and send it to the rest of the body. During episode of V-tach, the heart beats faster than normal and goes out of sync with the atria. The heart rate is usually 100 or more beats a minute with at least 3 irregular heartbeats in a row. Most patients who have V-tach have a heart rate that is 170 beats per minute or more. Heart rate is controlled by electrical impulses that trigger each contraction and determine the rhythm of the heart. V-tach disrupt the normal, orderly, coordinated contraction of the heart muscle. Rapid heartbeat does not give the ventricles enough to time to fill with blood before the heart contracts. As a result, the heart may not be able to pump enough blood to the rest of the body, thus reducing the heart’s efficiency. This often make V-tach a particularly dangerous cardiac arrhythmia. Brief episodes of V-tach can last for only a few seconds and may not cause any symptoms. Or it can last for more longer and cause symptoms like dizziness; shortness of breath; lightheadedness; palpitations (feeling as if the heart is racing); angina (chest pain) and seizures. Sustained or more serious episodes of V-tach may cause syncope (loss of consciousness) and even sudden cardiac arrest, which is life-threatening medical emergency.
Most of the time, V-tach develops because of an
underlying cardiac disorder such as coronary artery disease (CAD) or heart
failure that produces damage to the ventricular muscle. The risk of developing
V-tach is proportional to the amount of damage that has been sustained by the
ventricular muscle: the more damage, the greater the risk of the arrhythmia. The
best way to estimate the amount of heart muscle damage is to measure the left
ventricular ejection fraction. The lower the ejection fraction, the more
extensive the muscle damage and the higher the risk of having V-tach.
As V-tach is caused by a disruption in the normal electrical impulses that control the rate of the ventricles' pumping action, other things that can cause or contribute to problems with the heart’s electrical system include abnormal electrical pathways in the heart present at birth (congenital heart conditions, including long QT syndrome); structural heart disease (cardiomyopathy); medication side effects; an inflammatory disease affecting skin or other tissues (sarcoidosis); abuse of recreational drugs like cocaine; imbalance of electrolytes, mineral-related substances necessary for conducting electrical impulses. In some cases, the exact cause of T-tach cannot be determined (idiopathic ventricular tachycardia). Some form of V-tach may get worse and lead to ventricular fibrillation (V-fib), which is characterized by a rapid, inadequate heart rhythm. In this condition, the heartbeat is so fast and irregular that it causes the heart to stop working. V-fib is life-threatening as it can lead to cardiac arrest and even sudden death. Diagnosis of V-tach is made by doctors who perform a physical examination and run certain tests. During the examination, the doctor will listen to the heart and ask about the symptoms. Pulse and blood pressure will also be checked. If V-tach is suspected, the doctor will order certain tests, including ECG (electrocardiogram), CMRI (cardiac MRI) and transesophageal echocardiography. If treatment be received promptly, the outlook for victims with V-tach is usually good. The goal of treatment is to correct the heart rhythm immediately and to prevent future episodes. In an emergency, treatment for V-tach may include CPR, electrical defibrillation, electric shock and antiarrhythmic medication. Once the acute episode of V-tach is stopped and the heart rhythm restored to normal, the next step is to prevent future episode.
To prevent recurrent V-tach, it is necessary to
fully assess and treat the underlying cardiac disease. In most cases, this means
applying optimal therapy for CAD or heart failure, or both. Long-term treatment
may include oral antiarrhythmic medication, though these drugs are not always
prescribed due to their severe side effects. Other long-term treatment options
include implantable cardioverter defibrillator, radiofrequency ablation and
cardiac-resynchronization therapy. Date: February 27, 2020
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