ventricular tachycardia
DESCRIPTION
Ventricular tachycardia (VT) is a broad complex tachycardia originating from a ventricular ectopic focus. It is defined as three or more ventricular extrasystoles in succession at a rate of more than 120 beats per minute (bpm). Accelerated idioventricular rhythm refers to ventricular rhythms with rates of 100-120 bpmTRANSCRIPT
Dr Ramachandra
VentricularTachycardia
“I do not know what I may appear to the world, but to myself I seem to have been only like a boy playing on the sea-shore, and diverting myself in now and then finding a smoother pebble or a prettier shell than ordinary, whilst the great ocean of truth lay all undiscovered before me.” ― Isaac Newton
DefineArrhythmiaHR≥100/min Originates in the ventriclesWide QRS complexes (120 ms)
TypesIdiopathic vs. structuralSustained (>30sec) vs. non sustainedMonomorphic vs. polymorphic(≥5
continuous QRS has no clear isoelectric baseline)
With or without hemodynamic collapse
DiagnosisECG is enoughWide QRS:80% VT :20% SVT with
aberrancy/AVRT/etc
VT Cousins
VT Cousins
concordance=PolarityNegative: All QRS in V1-6 -VEPositive: All QRS in V1-6 +VE
ECG
QRS in MI looks Spine or sternum?
Poor R-wave progression and VT
Where they came from?
Bundle branch reentry -VT
Idiopathic Monomorphic VT
Aortic cusp-VT
Medical Rx of VT
Amiodarone….Contid
Major ICD trials
Catheter ablation
LONG QT
Bidirectional VT
T-dP
Rx that cause Brugada ECG
Rx algorithm in Brugada
Brugada vs. EPRS
NSVTNormal heart+NSVT=Rx to ↓ S/S/LVDNSVT burden ≥ 15%-20% of Holter=
Drug+RFAOld MI+NSVT=
1.EF≥40% -only symptomatic 2.EF=30-40% then EPS-then ICD 3.EF<30%-ICD
Success lies in detachment