Related Subjects:
| Classical Ventricular Tachycardia
| Idiopathic Ventricular Tachycardia
| Right Ventricular Outflow Tract Tachycardia
| Idiopathic Fascicular Left Ventricular Tachycardia
| Left Ventricular Outflow Tract Tachycardia
| Ventricular Fibrillation
| Resuscitation - Adult Tachycardia Algorithm
| Resuscitation - Advanced Life Support
| Automatic Implantable Cardioverter Defibrillator (AICD)
Idiopathic ventricular tachycardia in patients with an anatomically normal heart is a distinct entity whose management and prognosis differs from ventricular tachycardia associated with structural heart disease. Classic VT is still by far the most common cause of wide complex regular tachycardia. Assume Classical VT and all the risks associat until a Cardiologist has proven otherwise.
Classical VT is by far the most common cause of wide complex regular tachycardia, and there is no perfectly reliable way to distinguish classic VT with all its dangers from idiopathic VT or SVT with aberrancy on the surface 12-lead ECG.
About
Aetiology
Idiopathic VT Compared with Classic VT
Subtypes: See links above
Clinical
Investigations
Summary
Type of VT | QRS Morphology/Axis | Pharmacotherapy Sensitivity: Only after Specialist assessment | Treatment |
---|---|---|---|
RVOT VT /monomorphic extrasystoles | LBBB/ inferior axis | Adenosine, B-blocker, verapamil (or diltiazem) B-blocker, verapamil | RF ablation |
LVOT VT | S wave in lead I, R-wave transition in V1 or V2 | Adenosine, B-blocker, verapamil (or diltiazem) B-blocker, verapamil, | RF ablation |
Fascicular VT | RBBB/ left superior axis (exit posterior fascicle); RBBB/right inferior axis (exit anterior fascicle) | Verapamil | RF ablation |
Management: Treat as Classical VT unless a Cardiologist says otherwise
- ABC. If unstable have a low threshold to electrical cardioversion first and take specialist advice. Some of these respond to drugs such as Verapamil or Adenosine. Verapamil should only ever be given to a broad complex tachycardia thought to be an IVT after senior consultant/attending cardiology specialist advice and known good LV function (get echo if unsure). A normal quality echocardiogram is always reassuring and should be considered a priority.
- These arrhythmias are well tolerated usually. Needs specialist care. Only treat as IVT if there is a clear specialist diagnosis. Always be ready to DC convert.