Ventricular Tachycardia – Symptoms and Causes (2023)

Overview

Ventricular tachycardia heart rate

In ventricular tachycardia, an irregular electrical impulse that begins in the heart's lower chambers (ventricles) causes the heart to beat faster.

Ventricular tachycardia is a heart rhythm problem (arrhythmia) caused by irregular electrical signals in the lower chambers of the heart (ventricles). This condition is also known as V-tac or VT.

A healthy heart normally beats about 60 to 100 times per minute at rest. In ventricular tachycardia, the heart beats faster, usually 100 or more beats per minute.

Sometimes the rapid heartbeat prevents the heart chambers from filling with blood properly. As a result, the heart may not be able to pump enough blood to the body. If this happens you may feel short of breath or dizzy or you may lose consciousness.

Episodes of ventricular tachycardia can be brief, lasting only a few seconds without causing harm. But episodes longer than a few seconds (continuedV-tachometer) can be fatal. Sometimes ventricular tachycardia can cause cardiac arrest (sudden cardiac arrest).

Treatment for ventricular tachycardia may include medication, heart shock (cardioversion), catheter procedures, or surgery to slow the rapid heart rate and reset the heart rhythm.

What is ventricular tachycardia?

Mayo Clinic cardiologist Suraj Kapa, M.D., discusses common misconceptions about ventricular tachycardia.

I am Dr. Suraj Kapa, a Mayo Clinic cardiologist who specializes in cardiac arrhythmias. Today I am going to talk about the condition known as ventricular tachycardia. Now if you go online and look up ventricular tachycardia, you might be concerned because people say, oh, this is related to sudden death, or, oh, maybe you need urgent medical attention. But I'll try to clear things up a little bit for you, both on what this could be and how we might treat it.

Ventricular arrhythmias can occur in both structurally normal and structurally abnormal hearts. What we mean by that is that there are some patients who actually have no underlying heart disease other than an abnormality in the electrical system of the lower chambers or ventricles of the heart that can cause the heart to miss a beat. . They can appear as occasional extra beats that can be experienced as skipped beats or as a rapid series of beats that all happen one after the other, called ventricular tachycardia. In rare cases, if the heart is structurally normal, this can result in a dangerous rhythm, although this is also relatively rare if there is no other underlying heart condition that could be contributing.

However, in some patients, they may have an abnormal heart for other reasons. There are several reasons why the heart can become structurally abnormal, such as if you had a heart attack in the past or if you have a genetic abnormality that you may have inherited from your mother or father. You may have an inflammatory heart condition, such as sarcoidosis or myocarditis. All of these different syndromes can also contribute to electrical abnormalities in the lower chamber of the heart, but sometimes when people have what we call substrate, or abnormalities in the normal architecture of the heart, it can lead to ventricular arrhythmias. And in these patients, these ventricular arrhythmias can be potentially fatal.

However, when we observe the occurrence of these arrhythmias, we must take a systematic approach to their evaluation and treatment. So what do I mean by that? When we talk about evaluation, we look at the question: is there another reason why this happened? Were you on any medications, were there any abnormalities in your electrolyte levels, or what were you taking for other reasons, such as over-the-counter herbal remedies, that may have contributed to these arrhythmias? gone, if not, what else are we doing?

We're also trying to figure out how important the arrhythmia is. Is it life-threatening or not, because not everyone is. And so when we talk about treatment, we're looking at two broad areas. In patients who do not have dangerous ventricular arrhythmias, we seek treatment to improve quality of life or symptoms because some patients may experience a variety of symptoms attributable to these arrhythmias, including a feeling of interrupted or accelerated heartbeat, or even dizziness. But some may just feel tired.

But the other group that concerns us is those in which these arrhythmias can be potentially fatal. In other words, they can lead to sudden death. In these patients, we want to stratify the risk to find out if these cardiac arrhythmias are dangerous and how we can protect these patients from sudden death.

The basis of treatments that you can see when you go online is what is called a defibrillator. You may have seen it in commercials or TV shows where people run around with these electrodes, drop them on a patient and then deliver an electric shock. This is what a defibrillator does for patients at higher risk for ventricular arrhythmias. It stays in your body at all times and basically gives you an electric shock if your heart loses its rhythm so it can get back into its normal rhythm. But the defibrillator does not prevent cardiac arrhythmias; he is only there to save your life if it does.

To prevent arrhythmias from actually occurring, there are two mainstays of therapy. If we can't find another reversible cause, we can give you medicine. There are several drugs we can use. These drugs are called antiarrhythmics and are typically successful in 50% to 60% of patients. However, they can have side effects and in some patients they can cause more heart rhythm disturbances and sometimes dangerous heart rhythm disturbances that can also lead to sudden death. However, as long as patients are properly monitored and medication is started correctly, the chances of this occurring are very small.

Thank you for joining me today to learn more about ventricular tachycardia. In the next video, I'll take a closer look at what an ablation procedure entails.

Symptoms

When the heart beats too fast, it may not pump enough blood to the rest of the body. Therefore, organs and tissues may not receive enough oxygen. Signs and symptoms that occur during an episode of ventricular tachycardia are due to a lack of oxygen and may include:

chest pain (angina pectoris)
Dizziness
Rapid heartbeat (palpitations)
Dizziness
shortness of breath

Ventricular tachycardia may resolve spontaneously within 30 seconds (non-sustained tachycardia).V-tachometer) or longer than 30 seconds (persistentV-tachometerofTV). Short episodes may not cause any symptoms. but persistedTVcan cause serious problems, including:

pass out
Loss of consciousness
Cardiac arrest (sudden death)

When should you see a doctor?

There are many different things that can cause ventricular tachycardia. It's important to get a quick and accurate diagnosis and the right care. See your doctor if you or your child has a heartbeat problem. In some cases, urgent care is needed.

Call 911 or your local emergency number if someone has these symptoms:

Chest pain that lasts more than a few minutes
difficulty breathing
pass out

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Causes

Ventricular tachycardia is caused by faulty cardiac signaling that causes an accelerated heartbeat in the lower heart chambers (ventricles). The rapid heart rate prevents the ventricles from filling and contracting (contracting) to pump enough blood into the body.

Many things can cause or contribute to heart signaling problems and lead to ventricular tachycardia. These include:

Previous heart attack or other heart disease that caused scarring of the heart tissue (structural heart disease)
Poor blood supply to the heart muscle due to coronary artery disease
Congenital heart disease, including long QT syndrome
Imbalance of substances in the blood called electrolytes, such as potassium, sodium, calcium and magnesium
side effects of medicines
Use of stimulants such as cocaine or methamphetamine

Sometimes the exact cause of ventricular tachycardia cannot be determined (idiopathic ventricular tachycardia).

How does the heart beat?

typical heartbeat

In a typical heart rhythm, a small group of cells in the sinus node sends out an electrical signal. The signal then travels through the atria to the atrioventricular (AV) node and then travels to the ventricles, causing them to contract and pump blood.

To better understand the cause of ventricular tachycardia, it can be helpful to know how the heart works normally.

The heart consists of four chambers: two upper chambers (atria) and two lower chambers (ventricles).

The heart rhythm is controlled by a natural pacemaker (sinus node) in the right upper chamber (atrium). The sinus node sends out electrical signals that normally initiate each heartbeat. These electrical signals travel through the atria, causing the heart muscle to contract (contract) and pump blood into the ventricles.

The signals then reach a cluster of cells calledVANnode, where they slow down. This slight delay allows the ventricles to fill with blood. When electrical signals reach the ventricles, the ventricles contract and pump blood to the lungs or the rest of the body.

In a typical heart, this cardiac signaling process usually runs smoothly, resulting in a resting heart rate of 60 to 100 beats per minute.

In ventricular tachycardia, faulty electrical signaling in the lower chambers of the heart causes the heart rate to increase to 100 or more beats per minute.

Risk factors

Any condition that overloads the heart or damages heart tissue can increase the risk of ventricular tachycardia. Lifestyle changes or appropriate medical treatment for the following conditions and events can lower your risk:

Heart disease
side effects of medicines
Severe electrolyte imbalance
Use of stimulant drugs, such as cocaine or methamphetamine

A family history of tachycardia or other cardiac arrhythmias increases the chance that someone will develop ventricular tachycardia.

Complications

Complications of ventricular tachycardia depend on:

How fast the heart beats
How long does the rapid heartbeat last
If there are other heart conditions

Possible complications of ventricular tachycardia include:

Frequent fainting or unconsciousness
Cardiac insufficiency
Sudden death caused by cardiac arrest

Ventricular fibrillation

A dangerous condition associated with ventricular tachycardia is ventricular fibrillation (V-fib). InV-fib, the lower heart chambers contract very rapidly and in an uncoordinated manner.

This irregular rhythm is more common in people with heart disease or a previous heart attack. It can also occur in people with electrolyte imbalances (such as high or low potassium levels).

Ventricular fibrillation can cause sudden cardiac arrest and lead to death if not treated immediately.

Prevention

The best ways to prevent tachycardia are to maintain a healthy heart and prevent heart disease. If you already have heart disease, keep an eye on it and follow your treatment plan. Make sure you understand your treatment plan and take all medications as prescribed.

Take the following steps to keep your heart healthy:

Eat a balanced and nutritious diet.A diet low in saturated and trans fats and high in fruits, vegetables and whole grains helps keep your heart healthy.
Exercise and maintain a healthy weight.Being overweight increases the risk of developing heart disease. As a general goal, you should get at least 30 minutes of moderate exercise every day.
Control of blood pressure and cholesterol levels.Make lifestyle changes and take medications prescribed to control high blood pressure (hypertension) or high cholesterol.
Control the stress.Avoid unnecessary stress and learn strategies to manage and reduce stress.
Do not use illegal drugs.Do not use stimulants such as cocaine. If you need help stopping drug use or abuse, talk to your doctor about a program that's right for you.
Go for scheduled health checks.Get regular physical exams and report any new signs or symptoms to your doctor.
Limit alcohol.If you choose to drink alcohol, do so in moderation. For healthy adults, this means up to one drink per day for women and up to two drinks per day for men. Some people may need to avoid alcohol completely. Ask your doctor how much alcohol, if any, is safe for you.
Limit caffeine.If you drink caffeinated drinks, do so in moderation (no more than 1-2 drinks per day).
stop smokingIf you smoke and can't quit on your own, talk to your doctor about strategies or programs to help you quit.
Be careful with over-the-counter medications.Some cold and cough medicines contain stimulants that can increase your heart rate. Always tell your doctor about the medicines you are taking, even if you buy them without a prescription.

By Mayo Clinic staff

February 2, 2022