What is Ventricular Tachycardia

Ventricular tachycardia is a fast heartbeat that begins in the lower chambers of the heart (ventricles). It is a type of abnormal heart rhythm (arrhythmia). A normal heartbeat usually starts when an area in the heart called the sinoatrial (SA) node releases an electrical signal. With ventricular tachycardia, electrical signals in the lower part of the heart fire abnormally and interfere with the electrical signals sent out by the SA node.

A normal heart rate is 60–100 beats per minute. During an episode of ventricular tachycardia, the heart reaches 100 beats per minute or higher. This condition can be life-threatening and should be treated immediately.

What are the causes?

This condition is caused by abnormal electrical activity in the lower part of the heart. This may result from:

• Medicines.
• Diseases of the heart muscle (cardiomyopathy).
• The heart not getting enough oxygen. This may be caused by blood flow problems in the arteries.
• An inflammatory disease that affects multiple areas of the body (sarcoidosis).
• Drug use, such as cocaine, amphetamine, or anabolic steroid use.

What increases the risk?

You are more likely to develop this condition if:

• You have had a heart attack.
• You have:
  • Heart failure or cardiomyopathy.
  • Heart defects that you were born with (congenital heart defects).
  • Abnormal heart tissue.
  • Heart valves that leak or are narrow.
  • Diabetes.
  • An infection that affects the heart.
  • High blood pressure.
  • An overactive or underactive thyroid.
  • Sleep apnea.
  • A family history of stopped heartbeat (cardiac arrest) or coronary artery disease.
  • High cholesterol.
• You smoke.
• You drink alcohol heavily.
• You use drugs, such as cocaine.

What are the signs or symptoms?

Symptoms of this condition include:

• A pounding heartbeat.
• Feeling as if your heart is skipping beats or fluttering (palpitations).
• Shortness of breath.
• Anxiety.
• Dizziness.
• Light-headedness.
• Fainting.
• Chest pain.
• Cardiac arrest caused by an irregular heartbeat (arrhythmia).

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam.
• Electrocardiogram (ECG). This test is done to check for problems with electrical activity in the heart.
• Holter monitor or event monitor test. This test involves wearing a portable device that monitors your heart rate over time.

You may also have other tests, including:

• Blood tests.
• Chest X-ray.
• Echocardiogram. This test involves using sound waves to create images of the heart.
• Angiogram. During this test, dye is injected into your bloodstream, and then X-rays are taken. The dye lets your health care provider see how blood flows through your arteries.
• Exercise stress test. During this test, an ECG is done while you exercise on a treadmill.
• Cardiac CT scan or cardiac MRI.

How is this treated?

Treatment for this condition depends on the cause. Treatment may include:

• Medicines that slow the heart rate and return it to a normal rhythm (anti-arrhythmics).
• An electric shock (cardioversion) that makes the heart go back to a normal rhythm.
• An electrophysiology study. This procedure can help locate areas of heart tissue that are causing rapid heartbeats.
  • In this procedure, a thin, flexible tube (catheter) is inserted into one of your veins and moved to your heart to evaluate your heart’s electrical activity.
  • In some cases, the heart tissue that is causing problems may be killed with radiofrequency energy delivered through the catheter (radiofrequency ablation). This may help your heart keep a normal rhythm.
• An implantable cardioverter defibrillator (ICD). This is a small device that monitors your heartbeat. When it senses an irregular heartbeat, it sends a shock to bring the heartbeat back to normal. The ICD is implanted under the skin in the chest.
• Surgery to improve blood flow to the heart.
• Genetic counseling to check whether your family members are at risk for ventricular tachycardia.

Follow these instructions at home:

Lifestyle

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Do not use stimulant drugs, such as cocaine or methamphetamines.
• Maintain a healthy weight.
• Manage stress. Try to do this with relaxation exercises, yoga, quiet time, or meditation.

Eating and drinking

• Eat a healthy diet. This includes plenty of fruits and vegetables, whole grains, lean meats, and low-fat or fat-free dairy products.
• Avoid eating foods that are high in saturated fat, trans fat, sugar, or salt (sodium).
• Ask your health care provider if you may drink alcohol.
  • If alcohol triggers episodes of ventricular tachycardia, do not drink alcohol.
  • If alcohol does not trigger episodes, limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Exercise regularly. Aim for 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. Ask your health care provider what exercises are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Your symptoms get worse.
• You develop new symptoms, such as new palpitations.
• You feel depressed.

Get help right away if:

• You have an episode of ventricular tachycardia that lasts 30 seconds or more.
• You have chest pain.
• You have trouble breathing.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Ventricular tachycardia is a fast heartbeat that begins in the lower chambers of the heart. This condition can be life-threatening and should be treated immediately.
• This condition may be treated with medicines, electric shock, radiofrequency energy, surgery, or insertion of an implantable cardioverter defibrillator (ICD).
• Get help right away if you have chest pain, trouble breathing, or ventricular tachycardia symptoms that last more than 30 seconds.