VT: Ventricular tachycardia

VT: Ventricular tachycardia

Three or more ventricular beats in a row at a rate above 100 per minute is termed ventricular tachycardia. VT lasting > 30 seconds or requiring termination earlier due to hemodynamic compromise is called sustained ventricular tachycardia. Non sustained VT is one which lasts less than 30 seconds without hemodynamic compromise. Lignocaine is useful in the treatment of VT due to myocardial ischemia. Amiodarone is the sheet anchor of treatment of ventricular tachycardia in all other situations. Those with hemodynamic compromise need prompt cardioversion. Some types of ventricular tachycardia like fascicular VT or Belhassen VT respond to verapamil, still rarer ones respond to adenosine.

But verapamil and adenosine are not the drugs to be given in a usual case of VT. Certain types of recurrent ventricular tachycardia can be treated by radio frequency catheter ablation to prevent recurrence. The site of origin of tachycardia can be mapped using techniques like activation mapping and pace mapping. Higher modalities of mapping like electroanatomic mapping are available in some centres, which make the localisation of the focus easier. Recurrent ventricular tachycardia can be managed by pharmacological suppression as well as by the implantation of an implantable cardioverter defibrillator. ICD will sense the arrhythmia and deliver either a shock to terminate it or overdrive pacing to suppress it.