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Ventricular tachycardia is a type of arrhythmia that has a high heart rate, with more than 120 beats per minute. It occurs in the lower part of the heart, and can interfere with the ability to pump blood to the body, symptoms include feeling short of breath, tightness in the chest and the person may even faint.
This change can occur in apparently healthy people without symptoms and is usually benign, although it can also be caused by serious illnesses, which can even lead to death.
Ventricular tachycardia can be classified as:
- Unsupported: when it stops alone in less than 30 seconds
- Sustained: which is when the heart reaches over 120 beats per minute for more than 30 seconds
- Hemodynamically unstable: when there is hemodynamic impairment and requires immediate treatment
- Unceasing: which is sustained continuously and which recurs quickly
- Electric storm: when they happen 3 or 4 times within 24 hours
- Monomorphic: when there is the same QRS change with each beat
- Polymorphic: when the QRS changes with each beat
- Pleomorphic: when there is more than 1 QRS during an episode
- Torsades de pointes: when there is a long QT and rotation of the QRS peaks
- Scar reentry: when there is a scar on the heart
- Focal: when it starts in one place and spreads in different directions
- Idiopathic: when there is no associated heart disease
The cardiologist can know what the characteristics are after performing the electrocardiogram.
Symptoms of ventricular tachycardia
The symptoms of ventricular tachycardia can include:
- Fast heartbeat that can be felt in the chest;
- Accelerated pulse;
- There may be an increase in respiratory rate;
- Shortness of breath may be present;
- Chest discomfort;
- Dizziness and / or fainting.
Sometimes, ventricular tachycardia causes few symptoms, even at frequencies of up to 200 beats per minute, but it is still extremely dangerous. The diagnosis is made by the cardiologist based on the electrocardiogram, echocardiogram, cardiac magnetic resonance or cardiac catheterization exam.
Treatment options
The goal of treatment is to get your heart rate back to normal, which can be achieved with a defibrillator in the hospital. In addition, after controlling the heartbeat it is important to prevent future episodes. Thus, treatment can be done with:
Cardioversion: consists of an "electric shock" in the patient's chest with the use of a defibrillator in the hospital. The patient receives a sleeping medication during the procedure, and thus does not feel pain, which is a quick and safe procedure.
Use of medicines: indicated for people who do not show symptoms, but which is not as effective as cardioversion, and the likelihood of side effects is greater.
ICD implantation: The ICD is an implantable cardioverter defibrillator, similar to a pacemaker, which is indicated for people who have a high chance of presenting new episodes of ventricular tachycardia.
Ablation of small abnormal ventricular areas: through a catheter inserted into the heart or open heart surgery.
Complications are related to heart failure, fainting and sudden death.
Causes of ventricular tachycardia
Some situations that can cause ventricular tachycardia include heart disease, side effects of some medication, sarcoidosis and use of illicit drugs, but there are some cases in which the cause cannot be discovered.