Ventricular tachycardia pathophysiology

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Ventricular tachycardia Microchapters

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Differentiating Ventricular Tachycardia from other Disorders

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

The underlying mechanism of VT is due to automaticity arising in either the myocardium or in the distal conduction system. The most common underlying substrate for ventricular tachycardia is ischemic heart disease. The morphology of ventricular tachycardia often depends on its cause.

Pathophysiology

Monomorphic Ventricular Tachycardia

There are two reasons the morphology of the QRS does not vary in monomorphic ventricular tachycardia:

Polymorphic Ventricular Tachycardia


Monomorphic ventricular tachycardia
Monomorphic ventricular tachycardia

Bundle Branch Re-entrant Ventricular Tachycardia

  • Bundle branch reentry ventricular tachycardia usually occurs either in patients with structural heart disease or in patients with conduction disturbances with a structurally normal heart.
  • Bundle branch reentry is a macro-reentrant tachycardia that incorporates the His-Purkinje system, the bundle branches, and transseptal myocardial conduction in the circuit.
  • Typical bundle branch reentry tachycardia uses the right bundle as the anterograde limb and the left bundle as the retrograde limb.
  • Atypical bundle branch reentry uses the left bunde (anterior fascicle, posterior fascicle or both) as the antegrade limb and the right bundle as the retrograde limb.
  • The tachycardia appears as a typical left bundle branch block or right bundle branch block.

References

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