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(A-Z listing includes diseases, conditions, tests and procedures)
 

Ventricular Tachycardia

What is ventricular tachycardia?

Ventricular tachycardia (VT or V-tach) is a type of abnormal heart rhythm, or arrhythmia. It occurs when the lower chamber of the heart beats too fast to pump well and the body doesn't receive enough oxygenated blood.

Normal Sinus Rhythm Click image to enlarge

A normal heartbeat begins with an electrical impulse from the sinus node, a small area in the heart's right atrium (right upper chamber). Ventricular tachycardia begins in the lower chambers (ventricles) and is quite fast. When it lasts only a few seconds, ventricular tachycardia may cause no problems. But when sustained, ventricular tachycardia can lower the blood pressure, resulting in syncope (fainting) or lightheadedness. Ventricular tachycardia can also lead to ventricular fibrillation (a life-threatening arrhythmia) and cardiac arrest.

Ventricular Tachycardia Click image to enlarge

What causes ventricular tachycardia?

Structural Heart Disease

Ventricular tachycardia most often occurs when the heart muscle has been damaged and scar tissue creates abnormal electrical pathways in the ventricles. Causes include:

  • Heart attack

  • Cardiomyopathy or heart failure

  • Myocarditis

  • Heart valve disease

Idiopathic Ventricular Tachycardia

Sometimes, people with no known heart disease can develop ventricular tachycardia, often due to an irritable focus — when cells outside the sinus node start generating an electrical impulse automatically on their own. This form of ventricular tachycardia is easier to address and is usually not life threatening.

Follow the journey: Finding the right arrhythmia treatment

The victim of an unexpected ventricular fibrillation, James Cromwell was saved by the intervention of Johns Hopkins electrophysiologists. But the initial approach wasn’t enough to comfortably control his severe condition. So doctors tried something new: they tracked down the patch of heart cells causing the extra beats and destroyed them.

What are the symptoms of ventricular tachycardia?

When ventricular tachycardia lasts a short time, there may be no symptoms except palpitations — a fluttering in the chest. But ventricular tachycardia lasting more than 30 seconds may cause more severe symptoms:

  • Chest pain

  • Dizziness

  • Fainting (syncope)

  • Shortness of breath

  • Cardiac arrest

How is ventricular tachycardia treated?

  • 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 delivers an electrical pulse to the heart to reset a dangerously irregular heartbeat

  • Medication: A number of antiarrhythmic medications are used to prevent ventricular tachycardia. These include:

    • Sotolol

    • Flecainide

    • Propafenone

    • Amiodarone

Learn more about arrhythmias or visit the Johns Hopkins Electrophysiology and Arrhythmia Service.

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