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Ventricular tachycardia

This factsheet is for people who have ventricular tachycardia, or who would like information about it.

Ventricular tachycardia causes the heart to beat too fast, usually at a rate of 120 to 200 beats per minute. Ventricular tachycardia is a type of arrhythmia (irregular heart rhythm) caused by faulty electrical signals in the heart.

Click on the tabs below for more information about ventricular tachycardia.

Published by Bupa's Health Information Team, June 2010.

The different types of heart arrhythmia

About

About

Tachycardia means a rapid heart rate of more than 100 beats per minute. Ventricular means that the problem starts in the lower chambers of the heart (the ventricles).

Ventricular tachycardia can be life threatening, especially if other heart problems already exist, such as heart disease or a history of heart attack.

What happens in ventricular tachycardia?

Your heartbeat is controlled by electrical signals (impulses), which start in a part of the heart wall called the sinus node and travel through the heart making it contract. The signals travel from the atria (the upper chambers of the heart) to the ventricles (the lower chambers) through an area called the atrioventricular (AV) node. The AV node helps to synchronise the pumping action of the atria and ventricles.

If you have heart block, there’s a problem affecting how these electrical signals are transmitted through your heart. When the problem occurs at the AV node, it prevents the signals being conducted from the atria to the ventricles. This is called AV block. There are three different degrees of AV block.
  • First-degree – the electrical signals are slowed as they pass through the AV node. There are rarely any symptoms.
  • Second-degree – not all electrical signals reach your ventricles. The signals can sometimes become increasingly delayed until one is blocked altogether, or it may be that every third or fourth signal is blocked. This type of heart block causes symptoms such as dizziness.
  • Third-degree (complete heart block) – this is the most serious type of heart block. It’s most common in adults with heart disease. It occurs when no electrical signals reach the ventricles from the atria and the ventricles end up producing their own electrical signals (called the escape rhythm). It usually results in a very slow heartbeat (bradycardia) and can cause a heart attack.
A heart block can also occur in the specialised group of electrical-conducting muscle fibres (the bundle of His) that emerge from the AV node, divide and lead into the right and left ventricles. This is called bundle branch block. It can affect the left- or right-hand side of your heart. Right bundle branch block (RBBB) doesn’t normally produce any symptoms. Left bundle branch block (LBBB) is the result of a heart problem such as ischaemic heart disease.


Symptoms and diagnosis

Symptoms and diagnosis

Symptoms of ventricular tachycardia


Symptoms of ventricular tachycardia may include:

  • palpitations – you’re aware of your heart beating faster or more forcefully
  • chest pain or discomfort
  • shortness of breath
  • severe dizziness
  • fainting
These symptoms may be caused by problems other than ventricular tachycardia if you have them get urgent medical advice.

Diagnosis of ventricular tachycardia


Heart block is often found by chance when having tests for other problems. The doctor will ask about your symptoms and examine you. He or she may also ask you about your medical history.
Some medicines such as beta-blockers, can slow down your heart rate. The doctor will review any medicines that you’re taking to make sure they’re not causing your heart block.

He or she will also do tests to find out if any underlying disease or condition such as anaemia or poor liver function is causing your symptoms.

The doctor may refer you to a cardiologist (a doctor specialising in conditions affecting the heart) for further tests.

You may have the following tests to confirm your diagnosis.

  • Blood tests – to check for anaemia and liver function.
  • Electrocardiogram (ECG) – measures the electrical activity in your heart to see how well it’s working.
  • Echocardiogram – uses ultrasound to produce a clear image of your heart muscles and valves.
  • 24-hour heart monitor – to record your heart rate.
  • Electrophysiology – to discover which part of your heart is responsible for heart block.
  • Tilt-table – to check for an abnormal rhythm by using changes in your position.
  • MRI scan – uses powerful magnets, radio waves and digital technology to produce detailed images of your heart muscles and valves.
Please note that availability and use of specific tests may vary from country to country.

Causes and complications

Causes and complications

Causes of ventricular tachycardia


Many conditions that affect the heart or blood circulation can cause ventricular tachycardia:
  • high blood pressure
  • heart valve disease
  • heart muscle disease (cardiomyopathy)
  • coronary heart disease
  • congenital heart disease (problems of the heart since birth)
Certain factors can trigger ventricular tachycardia:

  • certain medicines
  • emotional or physical stress (including exercise)
Some people develop ventricular tachycardia without having any underlying cause or risk factor.

Complications of ventricular tachycardia


If you have heart disease or have had a heart attack in the past, ventricular tachycardia can lead to a life-threatening condition called ventricular fibrillation. This is fatal unless corrected within a minute or two.

Treatment

Treatment

Treatment of ventricular tachycardia is aimed at stopping attacks if necessary, treating symptoms and preventing future attacks.

Emergency treatment


A ventricular tachycardia attack can sometimes stop by itself. However, if the attack is sustained (lasts for longer than 30 seconds) you may need hospital treatment to stop it.

You may be given an anti-arrhythmic medicine such as amiodarone through a drip in your arm to get your heart rhythm back to normal. This is known as chemical or medical cardioversion.

If you’re having symptoms such as breathlessness, dizziness and chest pain, or are falling unconscious, it means that there may be an immediate risk of your condition getting worse and your heart going into ventricular fibrillation. This can be fatal. You will need to have an emergency procedure called an electrical (DC) cardioversion. In this procedure, under a general anaesthetic, controlled electrical current is applied to your chest via a machine called a defibrillator, to help restore your heart to its normal rhythm.

Medicines


There are several different types of medicine that can help control your heart rate and rhythm, including beta-blockers, calcium channel blockers and anti-arrhythmic medicines.

A doctor may prescribe a combination of any of these medicines. You may have to take them for just a short period until you have other treatment such as electrical cardioversion to restore your heart rhythm, or you may have to take them for months or years. Alternatively, you may be given medicine to take just when you get symptoms.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Surgery


Surgery is only used when your symptoms haven’t responded very well to other treatments. You may need to have an implantable cardioverter defibrillator (ICD).

An implantable cardioverter defibrillator (ICD) is a device implanted under the skin near your collarbone. It monitors your heartbeat and when it detects you’re having ventricular tachycardia, it produces electrical signals to your heart to correct it. If a more serious rhythm should develop, an internal shock can be delivered to correct it.

Sometimes catheter ablation may be done. This is when small tubes called electrode catheters are passed into your veins in the groin and threaded up to the heart. Abnormal tissue which is disrupting the electrical signals in your heart is burnt or frozen.

Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.

Sources

Sources

  • Tachycardia. Arrhythmia Alliance. www.heartrhythmcharity.org.uk, accessed 31 March 2010
  • Palpitations. Clinical Knowledge Summaries. www.cks.nhs.uk, March 2009
  • Heart rhythms booklet. Ventricular tachycardia. British Heart Foundation. www.bhf.org.uk, accessed 31 March 2010
  • Ventricular tachycardia. Merck Manual Online. www.merck.com/mmhe, accessed 31 March 2010
  • Supraventricular and ventricular arrhythmias. British National Formulary 59. www.bnf.org, accessed 31 March 2010
  • Resuscitation guidelines: peri-arrest arrhythmias. Resuscitation Council UK, 2005. www.resus.org.uk, accessed 31 March 2010
  • Ventricular tachycardia. American Heart Association. www.americanheart.org, accessed 31 March 2010
  • Keep your heart healthy. British Heart Foundation. www.bhf.org.uk, accessed 31 March 2010

This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. This content was compiled by Bupa based on clinical information and practice current as at the stated date of publication. Content is likely to reflect clinical practice in a particular geographical region (as indicated by the sources cited) – accordingly, it may not reflect clinical practice in the reader’s country of habitation. This content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Photos and videos are only for illustrative purposes and do not reflect every presentation of a condition.

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