Ventricular tachycardia natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Ventricular tachycardia can cause life-threatening or fatal hemodynamic compromise or it can degenerate into a life-threatening rhythm called ventricular fibrillation. In general, supraventricular tachycardia with aberrancy is generally better tolerated and is not necessarily a medical emergency. Common complications of ventricular tachycardia include sudden cardiac death, cardiomyopathy, ventricular fibrillation, and infection related to ICD. Prognosis of ventricular tachycardia in patients largely depends upon the presence and severity of underlying cardiac disease.

Natural History

Ventricular tachycardia can cause life-threatening or fatal hemodynamic compromise or it can degenerate into a life-threatening rhythm called ventricular fibrillation. In general, supraventricular tachycardia with aberrancy is generally better tolerated and is not necessarily a medical emergency. An exception is if the the wide complex tachycardia is due to atrial fibrillation conducting down a bypass track such as is seen in Wolff-Parkinson-White syndrome (WPW) in which case the rhythm can degenerate into life-threatening ventricular fibrillation.

Complications

Common complications of ventricular tachycardia include:[1]

Prognosis

  • Prognosis of ventricular tachycardia in patients largely depends upon the presence and severity of underlying cardiac disease.[2][3]
  • In patients without evidence of ischemia or structural heart disease, prognosis is generally good.
  • Meanwhile, patients with underlying cardiac pathology may require lifelong medical therapy with medications, catheter ablation, and/or implantable cardioverter defibrillator (ICD) placement.

References

  1. Peichl P, Wichterle D, Pavlu L, Cihak R, Aldhoon B, Kautzner J (August 2014). "Complications of catheter ablation of ventricular tachycardia: a single-center experience". Circ Arrhythm Electrophysiol. 7 (4): 684–90. doi:10.1161/CIRCEP.114.001530. PMID 24958396.
  2. Trappe, Hans-Joachim; Brugada, Pedro; Talajic, Mario; Bella, Paolo Della; Lezaun, Roman; Mulleneers, Rob; Wellens, Hein J.J. (1988). "Prognosis of patients with ventricular tachycardia and ventricular fibrillation: Role of the underlying etiology". Journal of the American College of Cardiology. 12 (1): 166–174. doi:10.1016/0735-1097(88)90370-1. ISSN 0735-1097.
  3. Trappe HJ, Brugada P, Talajic M, Della Bella P, Lezaun R, Mulleneers R, Wellens HJ (July 1988). "Prognosis of patients with ventricular tachycardia and ventricular fibrillation: role of the underlying etiology". J. Am. Coll. Cardiol. 12 (1): 166–74. doi:10.1016/0735-1097(88)90370-1. PMID 3379202.

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