Ventricular tachycardia natural history, complications and prognosis: Difference between revisions

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{{Ventricular tachycardia}}
{{Ventricular tachycardia}}
{{CMG}} ; {{AE}} {{ADG}}
{{CMG}} ; {{AE}} {{Sara.Zand}} {{ADG}}


==Overview==
==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.
[[Ventricular arrhythmia]] may include the range from  triple premature [[ventricular contraction ]]s ([[PVC]]s) to [[ ventricular fibrillation]]. Clinical presentation varies from asymptomatic to [[cardiac arrest]].
[[Ventricular tachycardia]] can cause life-threatening or fatal [[hemodynamic compromise]] or it can degenerate into a life-threatening rhythm called [[ventricular fibrillation]].  Common complications of [[ventricular tachycardia]] include [[sudden cardiac death]], [[cardiomyopathy]], [[ventricular fibrillation]], and infection related to [[ICD]]. The prognosis of [[ventricular tachycardia]] in patients largely depends upon the presence and severity of underlying [[cardiac]] disease. [[Mortality]] of [[ventricular tachycardia]] is higher in [[patients]] with [[coronary artery disease]] and presence of [[LV]] dysfunction. Prognosis is generally good in [[patients]] with [[right ventricular dysplasia]], [[idiopathic ventricular tachycardia]] or [[ventricular fibrillation]]  treated medically. Contrary to previous studies, [[VT]] or [[VF]] at any time after [[STEMI]] was associated with higher [[mortality]] rate within 90 days. Late [[VT]] or [[VF]] (after 48 hours of hospital admission) after [[STEMI]] was associated with a higher risk of [[death]] than early [[VT]] or [[VF]] (within 48 hours of hospital admission).


==Natural History==
==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 tachycardias|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]].
* [[Ventricular arrhythmia]] may include the range from  triple premature [[ventricular contraction ]]s ([[PVC]]s) to [[ ventricular fibrillation]].
* Clinical presentation varies from asymptomatic to [[cardiac arrest]].
*[[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 tachycardias|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==
==Complications==
Common complications of ventricular tachycardia include:<ref name="pmid24958396">{{cite journal |vauthors=Peichl P, Wichterle D, Pavlu L, Cihak R, Aldhoon B, Kautzner J |title=Complications of catheter ablation of ventricular tachycardia: a single-center experience |journal=Circ Arrhythm Electrophysiol |volume=7 |issue=4 |pages=684–90 |date=August 2014 |pmid=24958396 |doi=10.1161/CIRCEP.114.001530 |url=}}</ref>
Common complications of [[ventricular tachycardia]] include:
 
*[[Ventricular fibrillation]]
*[[Sudden cardiac death]]
*[[Sudden cardiac death]]
*[[Cardiomyopathy]]
*[[Cardiomyopathy]]
*Infection related to [[implantable cardioverter defibrillator]]
*Infection related to [[implantable cardioverter defibrillator]]<ref name="pmid24958396">{{cite journal |vauthors=Peichl P, Wichterle D, Pavlu L, Cihak R, Aldhoon B, Kautzner J |title=Complications of catheter ablation of ventricular tachycardia: a single-center experience |journal=Circ Arrhythm Electrophysiol |volume=7 |issue=4 |pages=684–90 |date=August 2014 |pmid=24958396 |doi=10.1161/CIRCEP.114.001530 |url=}}</ref>
*[[Ventricular fibrillation]]


==Prognosis==
==Prognosis==


* Prognosis of ventricular tachycardia in patients largely depends upon the presence and severity of underlying cardiac disease.<ref name="TrappeBrugada1988">{{cite journal|last1=Trappe|first1=Hans-Joachim|last2=Brugada|first2=Pedro|last3=Talajic|first3=Mario|last4=Bella|first4=Paolo Della|last5=Lezaun|first5=Roman|last6=Mulleneers|first6=Rob|last7=Wellens|first7=Hein J.J.|title=Prognosis of patients with ventricular tachycardia and ventricular fibrillation: Role of the underlying etiology|journal=Journal of the American College of Cardiology|volume=12|issue=1|year=1988|pages=166–174|issn=07351097|doi=10.1016/0735-1097(88)90370-1}}</ref><ref name="pmid3379202">{{cite journal |vauthors=Trappe HJ, Brugada P, Talajic M, Della Bella P, Lezaun R, Mulleneers R, Wellens HJ |title=Prognosis of patients with ventricular tachycardia and ventricular fibrillation: role of the underlying etiology |journal=J. Am. Coll. Cardiol. |volume=12 |issue=1 |pages=166–74 |date=July 1988 |pmid=3379202 |doi=10.1016/0735-1097(88)90370-1 |url=}}</ref>
* [[Mortality]] of [[ventricular tachycardia]] is higher in [[patients]] with [[coronary artery disease]] and [[LV]] dysfunction.<ref name="pmid3379202">{{cite journal |vauthors=Trappe HJ, Brugada P, Talajic M, Della Bella P, Lezaun R, Mulleneers R, Wellens HJ |title=Prognosis of patients with ventricular tachycardia and ventricular fibrillation: role of the underlying etiology |journal=J. Am. Coll. Cardiol. |volume=12 |issue=1 |pages=166–74 |date=July 1988 |pmid=3379202 |doi=10.1016/0735-1097(88)90370-1 |url=}}</ref>
* In patients without evidence of ischemia or structural heart disease, prognosis is generally good.
* Prognosis is generally good in [[patients]] with [[right ventricular dysplasia]], [[idiopathic ventricular tachycardia]] or [[ventricular fibrillation]]  treated medically.
* Meanwhile, patients with underlying cardiac pathology may require lifelong medical therapy with medications, [[catheter ablation]], and/or [[Implantable cardioverter defibrillator|implantable cardioverter defibrillator (ICD)]] placement.
* Contrary to previous studies, [[VT]] or [[VF]] at any time after [[STEMI]] was associated with higher [[mortality]] rate within 90 days.
* Late [[VT]] or [[VF]] (after 48 hours of hospital admission) after [[STEMI]] was associated with a higher risk of [[death]] than early [[VT]] or [[VF]] (within 48 hours of hospital admission).<ref name="pmid2565684">{{cite journal |vauthors=Volpi A, Cavalli A, Franzosi MG, Maggioni A, Mauri F, Santoro E, Tognoni G |title=One-year prognosis of primary ventricular fibrillation complicating acute myocardial infarction. The GISSI (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto miocardico) investigators |journal=Am J Cardiol |volume=63 |issue=17 |pages=1174–8 |date=May 1989 |pmid=2565684 |doi=10.1016/0002-9149(89)90174-4 |url=}}</ref>


==References==
==References==

Latest revision as of 03:22, 22 May 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Aditya Ganti M.B.B.S. [3]

Overview

Ventricular arrhythmia may include the range from triple premature ventricular contraction s (PVCs) to ventricular fibrillation. Clinical presentation varies from asymptomatic to cardiac arrest. Ventricular tachycardia can cause life-threatening or fatal hemodynamic compromise or it can degenerate into a life-threatening rhythm called ventricular fibrillation. Common complications of ventricular tachycardia include sudden cardiac death, cardiomyopathy, ventricular fibrillation, and infection related to ICD. The prognosis of ventricular tachycardia in patients largely depends upon the presence and severity of underlying cardiac disease. Mortality of ventricular tachycardia is higher in patients with coronary artery disease and presence of LV dysfunction. Prognosis is generally good in patients with right ventricular dysplasia, idiopathic ventricular tachycardia or ventricular fibrillation treated medically. Contrary to previous studies, VT or VF at any time after STEMI was associated with higher mortality rate within 90 days. Late VT or VF (after 48 hours of hospital admission) after STEMI was associated with a higher risk of death than early VT or VF (within 48 hours of hospital admission).

Natural History

Complications

Common complications of ventricular tachycardia include:

Prognosis

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 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.
  3. Volpi A, Cavalli A, Franzosi MG, Maggioni A, Mauri F, Santoro E, Tognoni G (May 1989). "One-year prognosis of primary ventricular fibrillation complicating acute myocardial infarction. The GISSI (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto miocardico) investigators". Am J Cardiol. 63 (17): 1174–8. doi:10.1016/0002-9149(89)90174-4. PMID 2565684.