Overview of ventricular tachycardia
Ventricular tachycardia is a very fast heart rhythm that begins in the ventricles. The ventricles are the two lower chambers of the heart. They fill with blood from the atria, or top chambers of the heart, and send it to the rest of the body. Ventricular tachycardia is a pulse of more than 100 beats per minute with at least three irregular heartbeats in a row. It is caused by a malfunction in the heart’s electrical system.
Your heart rate is controlled by electrical impulses that trigger each contraction and determine the rhythm of the heart. When this process is disrupted and the electrical signals are sent too quickly, ventricular tachycardia can occur. The rapid heartbeat doesn’t give the ventricles enough time to fill with blood before the heart contracts. As a result, the heart may not be able to pump enough blood to the rest of the body.
Ventricular tachycardia may only last for a few seconds or for much longer. It doesn’t always cause symptoms, but when symptoms occur, they may include lightheadedness, dizziness, and fainting. The condition most commonly affects people who have heart disorders, such as coronary artery disease and cardiomyopathy.
Ventricular tachycardia may eventually lead to ventricular fibrillation, which is characterized by a rapid, inadequate heart rhythm. In this condition, the heartbeat is so fast and irregular that it causes the heart to stop working. To prevent this complication from occurring, it’s important to get immediate treatment for ventricular tachycardia.
What causes ventricular tachycardia?
VT is produced in two ways:
- An abnormal heart circuit within the ventricular muscle that is set in motion or triggered (called reentry).
- The abnormal ventricular muscle becomes self-activated (automaticity).
VT can occur in an otherwise healthy or physically normal heart. It can also occur as a result of damage or a scar to the heart from a previous heart disease.
VT that occurs in the setting of structural heart disease is more concerning and often can be life-threatening. VT that occurs in a structurally normal heart can be benign if it stops on its own.
Any heart condition that results in damage and scar to ventricular muscle can produce VT. It also caused by an inherited arrhythmia such as long QT syndrome or Brugada syndrome.
Ventricular tachycardia symptoms
You may not notice any symptoms, particularly if your heart beats fast for only a few seconds.
VT can cause:
- Feeling lightheaded or dizzy
- Chest pain
- Heart palpitations
- Shortness of breath
- Tightness in your neck
- Stopped heart (cardiac arrest)
Diagnosis in ventricular tachycardia
The healthcare provider will look for:
- Loss of consciousness
- Normal or low blood pressure
- Rapid pulse
Tests that can be used to detect ventricular tachycardia include:
- Holter monitor
- Intracardiac Electrophysiology Study (EPS)
- Beat monitoring with a loop recorder or device.
You may also have blood tests and other tests.
Treatment for ventricular tachycardia
Radiofrequency ablation: A minimally invasive procedure to destroy the cells that cause ventricular tachycardia; less effective when there is structural heart disease
Implantable cardioverter-defibrillator (ICD): An implanted device that sends an electrical pulse to the heart to restore a dangerously irregular heartbeat.
Medications: Several antiarrhythmic medications are used to prevent ventricular tachycardia. These include:
Any condition that puts pressure on the heart or damages heart tissue can increase the risk of ventricular tachycardia. Lifestyle changes or medical treatment can lower the risk associated with the following factors:
- Heart disease
- Side effects of medications
- Serious electrolyte imbalances
- Use of tonic drugs such as cocaine or methamphetamine.
If you have family antiquity of ventricular tachycardia or other heart rhythm disorders, you may be at augmented risk for ventricular tachycardia.
Ventricular tachycardia complications vary in severity and depend on how fast the heart beats, how long the fast heartbeat lasts, how often the tachycardia occurs, and the overall health of your heart. Possible complications include:
- Frequent fainting or loss of consciousness
- Heart failure
- Sudden death caused by cardiac arrest
- Ventricular fibrillation
A dangerous condition connected to ventricular tachycardia is ventricular fibrillation (V-fib). In V-fib, the lower chambers of your heart contract in a very rapid and uncoordinated manner.
This abnormal rhythm occurs more often in people with heart disease or a previous heart attack. It can also occur due to electrolyte problems (such as high or low potassium levels) or, rarely, in otherwise normal hearts. Ventricular fibrillation can also cause sudden cardiac arrest and death if not treated right away.
The best way to prevent ventricular tachycardia is to treat or eliminate risk factors that may lead to heart disease. If you already have heart disease, follow your treatment plan and a heart-healthy lifestyle.
Take the following steps:
- Exercise and eat a healthy diet. Live a heart-healthy lifestyle by exercising regularly and eating a healthy, low-fat diet that’s rich in fruits, vegetables and whole grains.
- Control stress. Avoid unnecessary stress and learn coping techniques to handle normal stress healthily.
- Go to scheduled checkups. Have regular physical exams and report any signs or symptoms to your doctor.
- Limit alcohol. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. For some conditions, it’s recommended that you completely avoid alcohol. Ask your doctor for advice specific to your condition.
- Limit caffeine. If you drink caffeinated beverages, do so in moderation (no more than one to two beverages daily).
- Stop smoking. If you smoke and can’t quit on your own, talk to your doctor about strategies or programs to help you break a smoking habit.