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If you want to learn about
supraventricular tachycardia (SVT), go to the topic
tachycardia is a fast heart rhythm that starts in the lower part of the heart
(ventricles). If left untreated, some forms of ventricular tachycardia may get
worse and lead to ventricular fibrillation, which can be life-threatening.
Ventricular tachycardia is a fast but regular rhythm. It can lead
to ventricular fibrillation which is fast and irregular. With ventricular
fibrillation, the heart beats are so fast and irregular that the heart stops
pumping blood. Ventricular fibrillation is a leading cause of sudden cardiac
is not known what causes ventricular tachycardia, especially when it occurs in
young people. But in most cases ventricular tachycardia is caused by heart
disease, such as a previous
heart attack, a
congenital heart defect,
hypertrophic or dilated cardiomyopathy, or
myocarditis. Sometimes ventricular tachycardia occurs
after heart surgery. Inherited heart rhythm problems, such as long QT syndrome or Brugada syndrome, are rare causes of ventricular tachycardia.
antiarrhythmic medicines, which are used to treat
other types of abnormal heart rhythms—can cause ventricular tachycardia. Less
common causes include blood imbalances, such as low
potassium levels and other
decongestants, herbal remedies (especially those that contain ma huang or
ephedra), diet pills, and "pep" pills often contain stimulants that can trigger
episodes of ventricular tachycardia. Illegal drugs (such as stimulants, like
cocaine) also may cause ventricular tachycardia. It is important to be aware of
which substances have an effect on you and how to avoid them.
In ventricular tachycardia,
the heart beats too rapidly and the ventricles cannot effectively pump
oxygen-rich blood to the rest of the body. Ventricular tachycardia can be
This heart rhythm is dangerous for most people. If it lasts more
than just a few seconds, it can turn into ventricular fibrillation which causes
electrocardiogram (EKG, ECG) can be done while
ventricular tachycardia is occurring, it often provides the most useful
information. An electrocardiogram is a tracing of the electrical activity of
your heart. It is usually done along with a history and physical exam,
lab tests, and a
tachycardia can occur intermittently and may not always be captured by an EKG
at the doctor's office, you may be asked to use a portable EKG to record your
heart rhythm on a continuous basis, usually over a 24-hour period. This is
referred to by several names, including ambulatory electrocardiography,
ambulatory EKG, Holter monitoring, 24-hour EKG, or cardiac event monitoring.
Your doctor may recommend further tests, including an
echocardiogram, to evaluate your heart's function, a stress test or coronary
angiogram to determine whether a part of the heart is not getting enough blood,
and/or an electrophysiology (EP) study. An EP study can locate specific areas of heart tissue that
give rise to abnormal electrical impulses, which may be causing the ventricular
tachycardia. This information is used to determine the best treatment.
If you are having symptoms and
are in a sustained tachycardia, it is a medical emergency. You will need
immediate treatment. You may need
CPR or a shock from an automatic defibrillator (also
known as an AED). Paramedics or your doctor may try intravenous medicines or
electrical cardioversion to return your heart to a
To prevent the arrhythmia from recurring, you may
need to take
Your doctor might recommend an implanted device,
implantable cardioverter defibrillator (ICD). An ICD can detect an abnormal heart rhythm and restore a normal rhythm.
In some cases a procedure
called catheter ablation is used to destroy small areas of heart tissue
responsible for the arrhythmia. Catheter ablation might make the arrhythmia happen less often or stop the arrhythmia from happening again.1
It is very important that any causes of
ventricular tachycardia be identified and treated, if possible. For example, if the ventricular tachycardia results from
a medicine, the medicine needs to be stopped.
Call 911 or other emergency services immediately if you have
palpitations, dizziness, near-fainting, or chest pain.
Talk with your doctor before changing your diet. If you want to lose weight, do not use diets that rely on a liquid-based program
or a high-protein regimen. These types of diets can affect the concentrations of electrolytes in your
blood. This can, in turn, cause problems with your heart.
Ask your doctor when you can drive again. If you have had an episode
of ventricular tachycardia or ventricular fibrillation, your doctor may
recommend that you don't drive a car for a few months. This precaution is to
make sure you don't have any other episodes that could make driving
unsafe. Right after you get an ICD implanted, you will not drive for at least a few days.
Travel safely. It is safe for most people with arrhythmias to travel. Plan ahead to travel safely. For example, plan to wear a medical alert bracelet and to bring enough medicine for the length of your trip.
Know how to live well with an ICD. This includes getting your device checked regularly, avoiding strong electric or magnetic fields, exercising safely, and knowing what to do if you get a shock.
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Aliot EM, et al. (2009). EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias. Heart Rhythm, 6(6): 886–933.
Other Works Consulted
Epstein AE, et al. (1996). Personal and public safety
issues related to arrhythmias that may affect consciousness: Implications for
regulation and physician recommendations. A medical/scientific statement from
the American Heart Association and the North American Society of Pacing and
Electrophysiology. Circulation, 94(5):
Epstein AE, et al. (2007). Addendum to Personal and
public safety issues related to arrhythmias that may affect consciousness:
Implications for regulation and physician recommendations: A medical/scientific
statement from the American Heart Association and the North American Society of
Pacing and Electrophysiology. Public safety issues in patients with implantable
defibrillators. A scientific statement from the American Heart Association and
the Heart Rhythm Society. Circulation, 115(9):
Epstein AE, et al. (2008). ACC/AHA/HRS 2008 Guidelines
for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the
American College of Cardiology/American Heart Association Task Force on
Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002
Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia
Devices): Developed in Collaboration With the American Association for Thoracic
Surgery and Society of Thoracic Surgeons. Circulation,
117(21): e350–e408. [Correction in Circulation, 120(5): e34–e35.]
Miller JM, Zipes DP (2012). Therapy for cardiac arrhythmias. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 710–744. Philadelphia: Saunders.
Olgin JE, Zipes DP (2012). Specific arrhythmias: Diagnosis and treatment. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 771–824. Philadelphia: Saunders.
Reynolds MR, et al. (2011). Sudden cardiac death. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 1, pp. 1139–1162. New York: McGraw-Hill.
Tung R, et al. (2011). Catheter ablation of ventricular tachycardia. Circulation, 123(20): 2284–2288.
Zipes DP, et al. (2006). ACC/AHA/ESC 2006 Guidelines
for Management of Patients With Ventricular Arrhythmias and the Prevention of
Sudden Cardiac Death: A Report of the American College of Cardiology/American
Heart Association Task Force and the European Society of Cardiology Committee
for Practice Guidelines (Writing Committee to Develop Guidelines for Management
of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac
Death). Circulation, 114(10): 1088–1032.
August 9, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & John M. Miller, MD, FACC - Cardiology, Electrophysiology
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