Ventricular Tachycardia

What Is Ventricular Tachycardia?

Ventricular tachycardia is an unusually fast heartbeat that starts in the lower part of your heart, the ventricles. It’s sometimes called VT or V-tach.

What is a normal heartbeat?

Your heart is a muscular pump with four chambers. The two upper ones are called the atria. The two lower ones are called the ventricles. They work together to pump blood throughout your body. Every day, a healthy heart beats about 100,000 times.

Your heartbeat is controlled by electrical signals. These signals follow a pattern. They start in the sinoatrial (SA) node. It’s in one of your atria and is often called your heart’s natural pacemaker.

The signal causes your atria to contract so blood moves into your ventricles. It then moves down to another part of your heart called the atrioventricular (AV) node. This tells your ventricles to contract and move the blood along.

What happens in ventricular tachycardia?

When you have VT, the electrical signals in your ventricles go off the wrong way. The pulses coming from your SA node are also affected.

Most regular heart rates are in the range of 60 to 100 beats a minute. Ventricular tachycardia can result in rates of 170 beats a minute or even more.

When this happens, your heart’s upper chambers don’t have time to refill and send that blood to the ventricles. So your blood doesn’t get pumped throughout your body the way it should.

In some instances, this condition can lead to ventricular fibrillation, a condition that causes very rapid and uneven heartbeats of 300 or more a minute. It is a life-threatening emergency.

Ventricular Tachycardia Symptoms

You may not notice any symptoms, especially if your heart beats fast for only a few seconds.

VT can cause:

• Feeling lightheaded or dizzy
• Chest pain
• Heart palpitations
• Shortness of breath
• Fainting
• Tightness in your neck
• Stopped heart (cardiac arrest)

When should I call a doctor?

See your doctor as soon as possible if you’ve felt lightheaded or dizzy, had rapid heartbeats, or have fainted.

Call 911 if you have chest pain and trouble breathing along with a very fast pulse.

Ventricular Tachycardia Causes and Risk Factors

You’re more likely to have ventricular tachycardia if you’re older or if someone in your family has a heart rhythm problem. Other conditions that can cause VT or raise your chances of it include:

• Damage from heart disease such as a heart attack, heart failure, heart valve disease, or inflammation of your heart muscle (myocarditis)
• Sarcoidosis, a condition that causes inflamed tissues to grow in your body
• Conditions passed down from your parents like long QT syndrome or Brugada syndrome
• Medicines
• Uneven levels of electrolytes in your blood
• Heavy use of alcohol or caffeine
• Recreational drugs

When doctors can’t find a cause, it’s called idiopathic ventricular tachycardia.

Ventricular Tachycardia Diagnosis

Your doctor will review your medical history and symptoms. You’ll also have some tests of your heart.

The first one you’ll probably get is called an EKG. It records your heart’s electrical activity.

Your doctor may also want you to get electrophysiology testing, which pinpoints problem areas in your heart.

Ventricular Tachycardia Treatment

You may not need to do anything if you don’t have symptoms or if episodes last less than 30 seconds. Otherwise, your treatment will depend on what’s causing the problem.

If a medication or caffeine is causing the VT, you might need to stop taking it.

Other treatments include:

• Cardioversion. Your doctor uses an electric shock to return your heart to its regular rhythm. This is a common emergency treatment, especially if VT happens along with fainting or low blood pressure.
• Medications to slow your heart rate such as amiodarone (Nexterone, Pacerone), flecainide (Tambocor), lidocaine (Lidopen), propafenone (Rhythmol SR), or sotalol (Betapace, Sotylize). These don’t work as well as cardioversion, and they can have side effects.
• Cardiac resynchronization therapy (CRT). Your doctor implants a small pacemaker near your collarbone. It sends signals to both ventricles to make them work together the way they should.
• An implantable cardioverter-defibrillator (ICD). This is a small device placed under the skin just below your collarbone. You may get it along with CRT. An ICD delivers a shock to reset your heartbeat if it becomes uneven. It can keep VT from causing a life-threatening problem.
• Cardiac ablation. This is also called catheter or radiofrequency ablation. Doctors use heat to destroy unusual heart tissue. This method treats the ventricular tachycardia and can cure it.

Ventricular Tachycardia-Related Conditions

Ventricular tachycardia starts in the lower chambers of your heart, but the upper part might also be the source of the problem.Supraventricular tachycardia (SVT) starts in your atria.

SVT has several forms and is the most common type of rapid-heartbeat problem in children, as well as adults who drink too much coffee or alcohol, smoke heavily, are under stress, aren’t sleeping well, or aren’t getting enough fluids.

This condition isn’t as urgent as ventricular tachycardia.

Ventricular Tachycardia Prevention

The best way to prevent VT is to keep your heart healthy.

• Eat a healthy diet low in cholesterol and salt.
• Limit stimulants like caffeine.
• Don’t smoke.
• Exercise regularly, and keep a healthy weight.
• Ask your doctor about over-the-counter medications that can trigger tachycardia.
• If your doctor prescribes any heart medicines, take them as directed.
• You may need surgery if you have problems with your heart valves.

Read more on: heart disease, atrial fibrillation