Ventricular tachycardia (VT) is a frequent irregular rhythm from an ectopic focus located in one of the ventricles.
Ventricular tachycardia begins and ends suddenly. In most cases, the frequency of the ventricular rhythm is in the range of 150-200 per 1 min.
The reasons
Ventricular tachycardia rarely occurs in a “healthy” heart. Most often, it is a complication of myocardial infarction and its consequences or myocarditis.
Another cause of ventricular tachycardia may be electrolyte disorders, drug and non-drug iatrogenic effects.
There are also ventricular tachycardias that occur with congenital or acquired long QT syndrome.
Ventricular tachycardia is often observed in patients with cardiomyopathies, heart defects against the background of heart failure of any etiology.
Symptoms
Unstable ventricular tachycardia in most cases is asymptomatic and is detected only with more or less long ECG monitoring. Although palpitations, dizziness, syncope, and chest pain serve as the reason for this study in some of these patients, these complaints do not often coincide with episodes of arrhythmia, probably due to its rapidly transient nature.
Diagnosis
Diagnosis is based on characteristic ECG data. A feature of their changes in unstable ventricular tachycardia, which is formed in the outflow tract of the right ventricle in persons without structural heart diseases, is the graph of the blockade of the left branch of the His bundle in combination with the deviation of the electrical axis of the heart to the right. In this case, episodes of ventricular tachycardia are often interspersed with ventricular extrasystoles of the same form and are separated from each other by only a few complexes of sinus rhythm (the so-called repetitive monomorphic ventricular tachycardia).
Treatment
Treatment of ventricular tachycardia should, as a rule, be carried out in a hospital. The most effective intravenous lidocaine (eg, 75 mg IV with a repetition of 50 mg every 5-10 minutes, monitoring the ECG and blood pressure, up to a total dose of 200-300 mg).
In a serious condition of the patient associated with tachycardia, electropulse treatment should not be postponed. Both supraventricular and ventricular tachycardia can be effective when taking 50-75 mg of etacizin (daily dose 75-250 mg), with ventricular tachycardia, etmozin is effective – 100-200 mg (daily dose 1400-1200 mg). After a paroxysm of tachycardia, an antiarrhythmic agent is indicated in small doses to prevent relapse, it is better to use a product that removed the paroxysm inside for this.