Ventricular Tachycardia

What is Ventricular Tachycardia?

Ventricular tachycardia or VT is a arrhythmia in which the ventricles of the heart work independently of the atria and at a high speed. The heart rate is more than 100 beats per minute. In VT, the synchronisation between the atria and ventricles is disturbed. If this disturbance lasts for a few seconds, it may not cause any problems. However, when it is continuous, it can cause a decrease in blood flow to vital organs. It can cause fainting and dizziness. Ventricular tachycardia can also lead to ventricular fibrillation (a serious arrhythmia) and sudden cardiac arrest.

Understanding ventricular tachycardia and its potential complications is crucial for early diagnosis and effective treatment.

Ventricular tachycardia
Ventricular tachycardia mechanism

What Causes Ventricular Tachycardia?

VT can occur in the presence of severe structural heart disease or in the absence of any heart disease. In order to understand the causes of VT and to determine the most effective treatment approach, it is very useful to make a simple classification. VTs can be roughly divided into three types.

Idiopathic VTs: These VTs that occur for no apparent reason are the most common type of VT. It is also called VT of unknown cause. They usually originate from what we call the outflow tract, that is, the part of the right heart that takes blood to the lungs, the aortic valve on the left, or areas close to them.

VTs in people with structural heart disease: As the name suggests, these are VTs that occur in the presence of an underlying structural heart disease. These diseases include

  • Previous heart attacks
  • Heart failure
  • Genetic diseases with enlarged heart muscle
  • History of ventricle-related heart surgery
  • Inflammation of the heart muscle called myocarditis
  • Other system diseases affecting the heart (such as sarcoidosis, amyloidosis, etc.)

VTs due to electrical system diseases: In these diseases, the heart appears normal with imaging methods such as ECHO or MRI. However, an electrical system disorder is detected on ECG. The most common ones are as follows;

  • Brugada syndrome (frequency in 1 in every 5000 people)
  • Short or long QT syndrome (may be congenital or due to the effect of certain medications)
  • Catecholaminergic polymorphic VT (1 in 10,000 people)

but many reasons can be counted.

What are the Symptoms of Ventricular Tachycardia?

If ventricular tachycardia is short-lived, it can usually be felt as heart palpitations. However, if it lasts longer, symptoms such as dizziness, fainting, chest pain or shortness of breath may occur.

Fast Heartbeat, Heart Palpitations: In VT, the heart beats much faster than normal. This can often be more than 100 beats.

Dizziness or fainting: Fast heartbeats can cause dizziness or fainting when the body does not get enough oxygen.

Chest Pain or Discomfort: Irregular contraction of the lower chambers of the heart can cause pain or discomfort in the chest area.

Shortness of Breath: A rapid increase in heart rate can make it difficult for the body to get the oxygen it needs, which can cause shortness of breath.

How to recognize ventricular tachycardia?

If your heart palpitations are captured by ECG or rhythm recording, it is possible to determine whether you have ventricular tachycardia. This can be difficult to record if heart palpitations are rare. Longer ECG recordings may be necessary. Electrophysiologic study (EP Studies) can also be used to reproduce palpitations and make a diagnosis, as well as play a very important role in treatment by burning the sites where VT originates.

How does ventricular tachycardia occur?

VT can occur in two ways. High-speed electrical signals can be emitted from a region, a focus in the ventricles, or an electrical cycle occurs in the affected or problematic area. The higher the speed of this loop, the faster your heart beats.

You can watch my video to better understand what VT is.

Ventricular Tachycardia Treatment?

Ventricular tachycardia treatment is planned to stop the palpitations in emergency situations, to prevent the recurrence of palpitations in the long term and to protect the patient against the risk to life. The components of this treatment are as follows

  • Medication
  • Treatments for the underlying disease
  • Cardioversion, shock therapy used to normalize the rhythm in emergencies
  • Ablation to find the cause of the arrhythmia and burn the affected area
  • It consists of shock pacemaker treatments.

VT Ablation Therapy?

One of the effective methods used to stop ventricular tachycardia and prevent its recurrence is ablation therapy. With ablation, the mechanism of the palpitations is found and the arrhythmia is neutralized by burning the area. The success rate is high and depends on the size of the arrhythmia site and the type and severity of the underlying heart disease.

VT Medication Treatment?

There are medications used to treat VT. These medications are sometimes used alone to control palpitations but are usually combined with ablation therapy.

Here are some of the frequently asked questions about ventricular tachycardia.

Can Ventricular Tachycardia be cured?

In some cases of ventricular tachycardia, ablation therapy can completely eliminate the disease and a shock pacemaker may not be necessary. These are ventricular tachycardias that develop in a structurally normal heart. The most common are

  • Fascicular VTs
  • VTs originating from the area we call the outflow tract

If you have structural heart disease, it may be necessary to wear a shock device, even if the arrhythmia is controlled by ablation or medication. Structural heart disease is a structural abnormality in the heart, such as enlargement, enlargement or regurgitation.

Shock pacemakers are also often necessary for VTs due to electrical disorders, even if the arrhythmia is controlled.

Is VT Dangerous?

Ventricular Tachycardia is a rhythm disorder that can be life-threatening in general. It can cause death. This risk is lower if you do not have structural or electrical heart disease, your blood pressure does not drop during VT, you do not experience dizziness or fainting, and the VT rate is relatively low. If the palpitations are very fast, if you have structural or electrical heart disease, or if fainting occurs, the risk to life will be higher.

How Does a VT Attack Happen?

In ventricular tachycardia, heart palpitations usually start suddenly. It can include a rapid heartbeat, dizziness, feeling faint or fainting, a feeling of heart compression and difficulty breathing. In these cases, you may need to seek emergency medical help.

Can I Prevent Ventricular Tachycardia?

Since an important cause of ventricular tachycardia is not congenital, but acquired heart disease (heart attack, heart failure, etc.), you can protect yourself by

  • Healthy eating habits
  • Avoiding smoking
  • Regular physical exercise
Fascicular ventricular tachycardia
Fascicular ventricular tachycardia

Reference: Ventricular Tachycardia

Update: Feb 14, 2024

Share this post
Picture of Prof. Dr. Taylan Akgün
Prof. Dr. Taylan Akgün

He is a cardiologist specialised in the diagnosis and treatment of heart rhythm problems (ablation), pacemaker procedures.
He works in Istanbul province.

Related Articles