Ventricular tachycardia (VT) is an arrhythmia originating in the ventricles with a heart rate over 100 beats per minute and wide QRS complexes of at least 120 ms. VT can be either idiopathic or structural, sustained or non-sustained, and monomorphic or polymorphic. The ECG can diagnose VT based on the wide QRS complexes. VT has subtypes including bundle branch reentry VT and idiopathic monomorphic VT. Treatment options include medical therapies like amiodarone, implantable cardioverter defibrillators based on major trials, and catheter ablation.

1. Dr Ramachandra
Ventricular
Tachycardia
“I do not know what I may appear to the
world, but to myself I seem to have been
only like a boy playing on the sea-shore, and
diverting myself in now and then finding a
smoother pebble or a prettier shell than
ordinary, whilst the great ocean of truth lay
all undiscovered before me.”
― Isaac Newton

2. Define
Arrhythmia
HR≥100/min
 Originates in the ventricles
Wide QRS complexes (120 ms)

3. Types
Idiopathic vs. structural
Sustained (>30sec) vs. non sustained
Monomorphic vs. polymorphic(≥5 continuous QRS has no
clear isoelectric baseline)
With or without hemodynamic collapse

4. Diagnosis
ECG is enough
Wide QRS:80% VT
:20% SVT with aberrancy/AVRT/etc

5. VT Cousins

6. VT Cousins

7. concordance=Polarity
Negative: All QRS in V1-6 -VE
Positive: All QRS in V1-6 +VE

8. ECG

9. QRS in MI looks Spine or sternum?

10. Poor R-wave progression and VT

11. Where they came from?

12. Bundle branch reentry -VT

13. Idiopathic Monomorphic VT

14. Aortic cusp-VT

15. Medical Rx of VT

16. Amiodarone….Contid

17. Major ICD trials

18. Catheter ablation

19. LONG QT

20. Bidirectional VT

21. T-dP

22. Rx that cause Brugada ECG

23. Rx algorithm in Brugada

24. Brugada vs. EPRS

25. NSVT
Normal heart+NSVT=Rx to S/S/LVD↓
NSVT burden ≥ 15%-20% of Holter= Drug+RFA
Old MI+NSVT=
1.EF≥40% -only symptomatic
2.EF=30-40% then EPS-then ICD
3.EF<30%-ICD

26. Success lies in detachment