Ventricular tachycardia is an abnormal heart rhythm originating from the lower chambers of the heart (ventricles), where the heart dangerously accelerates to 120-250 beats per minute. While normal heart rate is between 60-100 beats per minute, in ventricular tachycardia, it significantly exceeds normal values.
This extremely rapid rhythm disrupts the heart’s normal and regular contractions, reducing its ability to pump blood effectively. This is a serious arrhythmia that, if left untreated, can result in cardiac arrest or sudden cardiac death.
- What is Ventricular Tachycardia?
- What Causes Ventricular Tachycardia?
- What are the Risk Factors for Ventricular Tachycardia?
- What are the Symptoms of Ventricular Tachycardia?
- What are the Risks of Ventricular Tachycardia?
- How is Ventricular Tachycardia Diagnosed?
- How is Ventricular Tachycardia Treated?
- FAQs and Answers About Ventricular Tachycardia
What is Ventricular Tachycardia?
Ventricular tachycardia (VT) is a dangerous arrhythmia originating from the ventricles (lower chambers of the heart), where the heart rate exceeds 120 beats per minute. Under normal conditions, heart rhythm starts from the natural pacemaker (sinoatrial node) in the upper part of the heart and spreads regularly through the heart muscle. However, in VT, abnormal electrical signals form in a region of the ventricles or these signals enter a cycle, causing rapid heartbeats. This condition can lead to serious health problems by preventing the heart from pumping blood effectively.
Ventricular tachycardia is more common in patients who have had a heart attack or heart muscle damage. The most common symptoms of ventricular tachycardia include palpitations, chest pain, shortness of breath, dizziness, and in some patients, loss of consciousness. VT episodes may sometimes end spontaneously (non-sustained VT) or may last longer (sustained VT).
You can watch the video I prepared to better understand what ventricular tachycardia is.
What Causes Ventricular Tachycardia?
Various causes such as heart diseases, congenital heart defects (genetic), certain medications, electrolyte imbalances, heart attack, previous heart surgery can lead to ventricular tachycardia. Additionally, ventricular tachycardia can develop without any heart disease. It will be quite useful to make a simple classification to understand the causes of ventricular tachycardia and determine the most effective treatment approach. Ventricular tachycardia can be roughly divided into three categories.
Idiopathic Ventricular Tachycardia: These ventricular tachycardias that occur without an apparent cause are the most common type. They are also called ventricular tachycardia of unknown cause. They usually originate from what we call the outflow tract, either from the right heart part that carries blood to the lungs, near the aortic valve on the left, or from areas close to these.
Ventricular Tachycardia in People with Structural Heart Disease: As the name suggests, these are ventricular tachycardias that occur in the presence of an underlying structural heart disease. These diseases include:
- Previous heart attacks
- Heart failure
- Genetic diseases characterized by heart muscle enlargement
- History of heart surgery related to ventricle
- Myocarditis, which is inflammation of the heart muscle
- Other systemic diseases affecting the heart (such as sarcoidosis, amyloidosis, etc.)
Ventricular Tachycardia Related 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 noticed on ECG. The most common ones are:
- Brugada syndrome (frequency is 1 in every 5000 people)
- Short or long QT syndrome (can be congenital or due to effects of certain medications)
- Catecholaminergic polymorphic ventricular tachycardia (1 in every 10,000 people)
What are the Risk Factors for Ventricular Tachycardia?
There are certain conditions and daily life triggers that increase the risk of developing ventricular tachycardia. It is important to know these risk factors and take necessary precautions:
- Electrolyte imbalances (especially potassium and magnesium)
- Drug interactions and toxicity
- Excessive alcohol consumption
- Stimulant substance use
- Excessive stress and fatigue
- Thyroid gland dysfunction
What are the Symptoms of Ventricular Tachycardia?
If ventricular tachycardia is short-lived, it usually appears as heart palpitations. However, if it lasts long, it can cause complaints such as weakness, fatigue, dizziness, fainting, chest pain, shortness of breath, and in serious cases, sudden cardiac death.
- Rapid heartbeat, heart palpitations: In ventricular tachycardia, the heart beats much faster than normal. This can usually be at a rate above 120 beats.
- Weakness and fatigue: Due to the heart’s inability to pump effectively, muscles cannot receive adequate blood. This condition causes a feeling of general weakness and extreme fatigue.
- Dizziness or fainting: Rapid heartbeats can cause dizziness or fainting when the body cannot get enough oxygen.
- Chest pain or discomfort: Irregular contractions of the lower chambers of the heart can cause pain or discomfort in the chest area.
- Shortness of breath: The rapid increase in heartbeats can make it difficult for the body to get the oxygen it needs, which can cause shortness of breath.
- Sudden cardiac death: Prolonged and untreated ventricular tachycardia can lead to complete loss of the heart’s normal pumping function and sudden cardiac death. This condition can particularly occur in people with underlying heart disease.
What are the Risks of Ventricular Tachycardia?
Among the risks of ventricular tachycardia, the most important is progression to ventricular fibrillation and sudden cardiac death. Additionally, it can lead to serious complications such as heart failure, cardiogenic shock, loss of consciousness (fainting), blood clots, and organ damage due to decreased blood flow. Therefore, early diagnosis and appropriate treatment are vital.
Cardiogenic shock is a life-threatening emergency characterized by insufficient blood and oxygen delivery to tissues as a result of the heart’s inability to pump adequate amounts of blood.
How is Ventricular Tachycardia Diagnosed?
The diagnosis of ventricular tachycardia requires a comprehensive approach. ECG is the primary diagnostic tool. In addition, Holter device, event recorder, electrophysiological study, cardiac imaging (echocardiography, cardiac MRI), blood tests for electrolyte levels, and in some cases genetic tests can be used.
How is Ventricular Tachycardia Treated?
The treatment options for ventricular tachycardia (VT) include medications, addressing underlying conditions, cardioversion, ablation therapy, and the implantation of an implantable cardioverter defibrillator (ICD). Among these, ablation therapy is particularly prominent in cases of recurrent episodes.
Treatment of Underlying Conditions
If ventricular tachycardia is caused by another medical condition, addressing the underlying issue can reduce or prevent episodes of rapid heart rate.
Medication Therapy
Certain medications are used in the treatment of VT. While these drugs can sometimes control episodes of rapid heartbeats on their own, they are often combined with ablation therapy for more effective results.
Ablation Therapy
Ablation is one of the most effective methods to stop ventricular tachycardia and prevent its recurrence. This procedure targets the mechanism of the arrhythmia, burning the problematic area to render it inactive. Ablation has a high success rate, which depends on the size of the arrhythmia area, the type of underlying heart condition, and its severity.
Cardioversion
This involves delivering a controlled electrical shock to restore an abnormal heart rhythm to normal.
Implantable Cardioverter Defibrillator (ICD)
An ICD is a device implanted in the chest that continuously monitors life-threatening arrhythmias. When a dangerous rhythm is detected, it automatically delivers an electrical shock to correct it.
FAQs and Answers About Ventricular Tachycardia
What is the course of ventricular tachycardia disease?
The course of the disease varies depending on the underlying cause, type of ventricular tachycardia (sustained or non-sustained), presence of structural heart disease, timing of treatment, patient compliance, and general health status. The condition can usually be managed with appropriate medical care and lifestyle changes, but requires careful monitoring and strict adherence to treatment plans.
Can Ventricular Tachycardia Be Cured?
In some cases of ventricular tachycardia, the disease can be completely eliminated with ablation therapy, and a shock pacemaker may not be necessary. These are ventricular tachycardias that develop in a structurally normal heart. The most common ones are:
- Fascicular ventricular tachycardia
- Ventricular tachycardia originating from what we call the outflow tract
If you have structural heart disease, even if the arrhythmia is controlled with ablation or medication, a shock device may need to be implanted. Structural heart disease is the presence of structural abnormalities in the heart such as enlargement, growth, or insufficiency.
In ventricular tachycardia due to electrical diseases, defibrillator pacemakers are usually necessary even if the arrhythmia is brought under control.
Is Ventricular Tachycardia Dangerous?
Ventricular tachycardia is generally a life-threatening arrhythmia. It can cause death. If you don’t have structural or electrical heart disease, if your blood pressure doesn’t drop during ventricular tachycardia, if you don’t experience dizziness or fainting, and if the ventricular tachycardia rate is relatively low, this risk is lower. If the palpitation is very fast, if you have structural or electrical heart disease, or if fainting occurs, the vital risk will be higher.
How Does a Ventricular Tachycardia Attack Occur?
In ventricular tachycardia, heart palpitations usually begin suddenly. It manifests as acceleration in your heartbeat, dizziness, feeling faint or fainting, feeling of heart constriction, and difficulty breathing. You may need emergency medical help in these situations.
Can I Prevent Ventricular Tachycardia?
Since a significant cause of ventricular tachycardia is acquired heart diseases (such as heart attack, heart failure) rather than congenital conditions, you can protect yourself in the following ways. With healthy eating habits, avoiding smoking, and regular physical exercise, you can prevent or slow down the formation of cardiovascular stenosis. By reducing your risk of heart attack, you can protect yourself from secondary ventricular tachycardia that might develop.
Reference: Ventricular Tachycardia