Highlights & Basics
- ECG findings for sustained ventricular tachycardia (VT) include wide QRS complex (duration >120 milliseconds) at a rate greater than 100 bpm.
- Patients may have a normal cardiac output or may be hemodynamically compromised during episodes of VT. Presence or absence of symptoms does not reliably differentiate VT from supraventricular tachycardia.
- Torsades de pointes is a polymorphic VT with a characteristic twisting morphology occurring in the setting of QT interval prolongation.
- Sustained VT is usually observed in ischemic and nonischemic cardiomyopathy, but idiopathic VT may also be observed in patients without structural heart disease.
- Among patients with prior myocardial infarction or nonischemic cardiomyopathy, VT is usually due to reentry involving regions of slowed conduction adjacent to scar.
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Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022 Oct 21;43(40):3997-4126.[Abstract][Full Text]
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS Guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018 Oct 2;72(14):e91-220.[Abstract]
Pedersen CT, Kay GN, Kalman J, et al. EHRA/HRS/APHRS expert consensus on ventricular arrhythmias. Heart Rhythm. 2014 Oct;11(10):e166-96.[Abstract][Full Text]
Panchal AR, Bartos JA, Cabañas JG, et al; Adult Basic and Advanced Life Support Writing Group. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-468.[Abstract][Full Text]
Cronin EM, Bogun FM, Maury P, et al. 2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. J Arrhythm. 2019 May 10;35(3):323-484.[Abstract][Full Text]
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