This presentation tells briefly about ventricular tachycardia, its causes, clinical features, ECG and treatment.

1. ‫الرحیم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬

2. VENTRICULAR
TACHYCARDIA
CAUSES. CLINICAL FEATURES, ECG AND TREATMENT

3. VENTRICULAR TACHYCARDIA
• It is a wide complex tachycardia (rate > 100/minute) with regular rate
and single QRS morphology.
• Non-sustained ventricular tachycardia (VT) is a series of repetitive
ventricular beats that have a duration of less than 30 seconds;
• sustained VT lasts for more than 30 seconds.

4. CAUSES
• It usually occurs in the presence of some underlying heart
disease and is rarely seen in normal hearts.

5. CLINICAL FEATURES
•The patient may be asymptomatic or may present with palpitations or
hemodynamic collapse.
• The assumption that a hemodynamically stable patient cannot have VT
is erroneous(wrong).

6. ELECTROCARDIOGRAM
• The width of the QRS complex is generally >0.16 second.
• Positive or negative concordance of the QRS complex across the pre-cordial leads (e.g. R waves
or S waves only).
• A monophasic "Rr" pattern in lead V 1 (termed rabbit ears) with a taller left ear.
• An indeterminate axis (between -90° and-180°).
• In severe underlying heart disease the QRS morphology may be variable (polymorphic VT). The
basal QT interval before onset of polymorphic VT is normal as compared to torsades de pointes.

7. TREATMENT
• If the patient is hemodynamically unstable in the form of hypotension, angina, heart failure or
altered sensorium, immediate cardioversion in synchronized mode is required.
• If the patient is stable, amiodarone and lidocaine are the drugs of choice.
• Amiodarone 150 mg intravenously over 10 minutes, then 1 mg/minute for 6 hours and then 0.5
mg/minute for next 18 hours.
• Lidocaine 1-1.5 mg/kg IV over 1 minute followed by infusion at 10-40 μg/kg/minute. A repeat
bolus of 50 mg may be required during the first 30 minutes to avoid sub therapeutic blood
levels.