Ventricular Tachycardia (Assessment and Plan): Difference between revisions
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- Medication review (QTc prolonging meds increase risk of polymorphic VT, Class IC antiarrhythmics) | - Medication review (QTc prolonging meds increase risk of polymorphic VT, Class IC antiarrhythmics) | ||
- | -If unstable --> ACLS (including defibrillation) | ||
-If stable: start either amiodarone 150 mg IV, then drip at 1 mg/min for 6 hours, then 0.5 mg/min for 18 hours or lidocaine 100 mg IV, then drip at 1 mg/ min [check levels] | |||
-Replete electrolytes (K > 4, Mg > 2): give mag sulfate 2g-4g immediately if looks like Torsades | |||
Latest revision as of 22:49, 14 October 2018
Author: William J Gibson MD,PhD
#Ventricular Tachycardia
Differential includes: SVT with aberrancy, SVT with pre-excitation, pacemaker mediated tachycardia.
Things to look for on baseline EKG: bundle branch block, QTc, Q-wave (-> scar), WPW, epsilon wave (-> ARVD), Brugada pattern
Monomorphic VT more commonly associated with scar. Polymorphic VT associated with ischemia.
Management:
- Medication review (QTc prolonging meds increase risk of polymorphic VT, Class IC antiarrhythmics)
-If unstable --> ACLS (including defibrillation)
-If stable: start either amiodarone 150 mg IV, then drip at 1 mg/min for 6 hours, then 0.5 mg/min for 18 hours or lidocaine 100 mg IV, then drip at 1 mg/ min [check levels]
-Replete electrolytes (K > 4, Mg > 2): give mag sulfate 2g-4g immediately if looks like Torsades