Ventricular Tachycardia - Causes, Symptoms, and Treatment

Introduction

The heart is divided into four chambers. The above two chambers are the left and right atrium, and the lower are the left and right ventricles. A normal heartbeat originates due to an electrical impulse from the sinus node. An unusual electric signal keeps repeating when this is altered, leading to the ventricle beating way too rapidly. The sinus node is a zone of peculiar cells in the heart's upper right chamber (right atrium). This particular region is responsible for the heart to beat in a standard rhythm by creating a stable pace of electrical impulses. However, this steady pace can alter according to physical or emotional activity, for instance, exercise, stress, or rest.

Ventricular tachycardia can be understood as a repeated short circuit in the sinus node, resulting in the atrium contracting abnormally fast and thus raising the heartbeat to dangerously high readings and leading to the ventricle contracting more rapidly. When ventricular tachycardia happens briefly and halts immediately, it is called paroxysmal ventricular tachycardia. But if this is continuous, it is claimed as persistent ventricular tachycardia, VT, or v-tach.

What Is Ventricular Tachycardia?

Tachycardia is an abnormal rhythm of the heart. When it is due to abnormal electrical activity in the ventricles (lower chambers of the heart), it is called ventricular tachycardia. This occurs because the heart pumps too fast, and the pumping of blood becomes inadequate. As a result, the body fails to get sufficient amounts of oxygenated blood.

What Are the Signs of Ventricular Tachycardia?

A patient suffering from ventricular tachycardia presents few clinical manifestations. However, this condition can seldom go unnoticed since it also tends not to show any signs or symptoms.

Below are some of the signs of ventricular tachycardia.

• A fluttering feeling in the chest.

• Dizziness.

• Lightheadedness or fainting.

• Chest discomfort or chest pain.

• Palpitations.

• Shortness of breath.

• Lethargy and fatigue.

• Rapid breathing.

• Nausea and vomiting.

• Cardiac arrest.

• Hypertrophic cardiomyopathy is due to the heart turning weak.

• Heart failure is a result of a combination of the above symptoms.

Who Is Affected by Ventricular Tachycardia?

Ventricular tachycardia is a moderately common phenomenon seen in the senile group of society. The majority of the newly recorded cases are paroxysmal. Ventricular tachycardia can occur in any individual. It is equally reported in both men and women. It should be noted that some age factors result in particular kinds of ventricular tachycardia.

Additionally, some kinds of ventricular tachycardia run in families. Thus, genetics can play a crucial role in acquiring this condition. Several other factors, such as underlying cardiovascular disease or a history of cardiac disorders, are also pivotal in getting affected.

What Are the Causes of Ventricular Tachycardia?

Numerous reasons have the potential to result in ventricular tachycardia.

Below are some of them.

• A history of cardiovascular disease.

• Congenital heart disorders.

• Episodes of a heart attack.

• Disproportionate electrolyte levels.

• Increased alcohol consumption.

• Digoxin toxicity.

• Long QT syndrome.

• Increased intake of caffeine and caffeine-related foods and beverages.

• Methamphetamine, cocaine, and other recreational drugs.

• Stress.

• Strenuous exercise.

• Myocarditis.

• Acute illness.

• Hypertrophic cardiomyopathy.

• Hypertension, meaning high blood pressure.

• Coronary artery disease.

• Heart tissue is getting scarred.

• Patients suffering from diabetes or chronic heart failure.

• COPD or chronic obstructive pulmonary disease.

• Aging.

Physiologically, there are three causes of tachycardia in the upper chamber of the heart: automaticity, re-entry, and triggered activity.

• Automaticity occurs when the sinus node starts functioning incorrectly due to the heart’s chemical elements going out of proportion. This is generally seen in the younger population.

• When an electrical signal that informs the heart cells to beat again sends the same information, it re-enters. This is usually found in the older population.

• When an electrical impulse repeatedly responds with a combination of incorrect reaction and the immediate correct response of the cells, it is called triggered activity.

What Are the Risk Factors of Ventricular Tachycardia?

Many risk factors can cause ventricular fibrillation. They can include:

• Family history of irregular heartbeat.

• Family history of heart disease.

• Coronary heart disease.

• Myocarditis.

• Heart failure.

• Have an enlargement of the heart (cardiomyopathy).

• Heart valve disease.

• Severe abnormalities in electrolyte levels.

• Cases of drug abuse.

How Does It Affect the Body?

As the heart pumps too fast, there is less blood supply to the various parts of the body. As a result, the chambers are not filled in completely before the next beat, which causes dizziness and heart palpitations.

How to Diagnose Ventricular Tachycardia?

The signs and symptoms of a patient generally suggest an underlying problem with the heart rhythm. Therefore, several medical tests are conducted to diagnose this condition.

• Recording a patient's medical history is essential to understand the patient's ongoing cardiovascular condition.

• Physical examination reveals any risk factors that may be present.

• Electrocardiography measures the heart's electrical activity with the help of sensors and electric pads in the chest.

• A Holter monitor is similar to an electrocardiograph, but it approximately records the heart activity for over two days.

• Ambulatory monitors, such as event or implantable monitors, which can be taken home for up to a month, can also help diagnose ventricular tachycardia.

• To understand the type of ventricular tachycardia, the healthcare professional may conduct a detailed electrophysiological heart study. This study is generally combined with catheter ablation.

How to Treat Ventricular Tachycardia?

The first step toward ventricular tachycardia treatment is not to manage any underlying cardiac condition. This is followed by correcting the specific part of the heart that produces the wrong electrical signals. This can be done after multiple diagnostic tools determine and locate the abnormality. Correction of the present cardiovascular condition generally tends to cure ventricular tachycardia.

The healthcare professional may then prescribe medications and therapy to improve irregular heartbeats. This is done only after a fine-tuned electrophysiological study of the heart. A surgical route is decided if there is no alternative way to treat ventricular tachycardia.

Some of the commonly used treatment options include:

• Radiofrequency Catheter Ablation (RCA): In this minimally invasive procedure, the heart tissue that causes the irregular heartbeat is destroyed using a catheter with an electric current. However, this is less effective when the irregularity is due to a structural defect in the heart.

• Implantable Cardioverter-Defibrillator (ICD): This device monitors the heart rhythm. When an irregular heartbeat occurs, it quickly sends an electrical signal and corrects it.

What Are the Complications of Ventricular Tachycardia?

Ablation is a highly safe procedure with high levels of success. However, there can be some complications in some cases.

They can include:

• Damage to the muscles or blood vessels in the heart.

• Bleeding.

• Blood clots.

• Infections.

Conclusion

Ventricular tachycardia is a fatal arrhythmia that needs emergency management according to advanced cardiovascular life support (ACLS) protocol. It requires to be reverted by electrical cardioversion by a direct current shock (defibrillator) if the patient is unstable. If not reverted, it can lead to cardiac arrest. Any signs or symptoms should not be ignored; medical care must be immediately sought.

Generally, ventricular tachycardia disappears, and people return to their everyday lives. Alternatively, multiple treatment modalities exist that eradicate this condition. Diet and exercise play a critical role in heart health. Thus, keeping track of one’s health and weight can reduce the risk of developing ventricular tachycardia.