Cardiac Arrhythmias —


Ventricular Tachycardia VT –

Three or more consecutive ventricular ectopic complexes (duration greater than 120 ms) occurring at a rate of 100 to 250 beats per minute.

Ventricular Tachycardia 1

Cardiac Arrhythmias Ventricular Tachycardia VT

Diagnosis of VT (ventricular tachycardia)


  • At least 3 consecutive wide QRS complexes
  • Rate at least 100 per minute
  • Usually rhythm is regular
  • Retrograde P wave seen
  • Usually AV dissociation is present
  • Associated with severe underlying heart disease
  • Concordance of direction of wide QRS in precordial leads (all the QRS in one direction) QRS axis abnormal (-90 to -180°)
  • QRS width more than 0.14 second (31/2 small squares)
  • Paroxysmal VT initiated by VPC.
Ventricular Tachycardia 3

Cardiac Arrhythmias Ventricular Tachycardia VT

Causes of VT  Ventricular Tachycardia


  • Although non-sustained VT may occasionally be well-tolerated,
  • Non-sustained VT lasts less than 30 sec. Sustained VT lasts more than 30 sec, and is much more likely to produce loss of consciousness or other life-threatening symptoms.
  • it often arises in hearts that have suffered ischemic damage or cardiomyopathic degeneration and may be a cause of sudden death.
  • IHD
  • Cardiomyopathies
  • Drug toxicity Idiopathic.
  • Metabolic disorders
  • Prolonged QT syndrome
Ventricular Tachycardia 2

Cardiac Arrhythmias Ventricular Tachycardia VT

Clinical features of ventricular tachycardia —


  • Cannon a waves
  • Underlying heart disease
  • Syncope.
  • Varying first heart sounds
  • Hypotension


Treatment of Ventricular tachycardia —


  • The acute treatment of sustained VT is outlined in advanced life support protocols but may include the administration of lidocaine or other antiarrhythmic drugs, cardioversion, or defibrillation.
  • Chronic, recurring VT may be treated with sotalol, amiodarone, or implantable cardioverter-defibrillators.
  • Asymptomatic, nonsustained VT may not be treated.
  • Congenital long QT has to be treated due to risk of sudden death.
  • For sustained VT, VT with organic heart disease, hemodynamic compromise, CHF, and CNS hypoperfusion, prompt DC cardioversion is done. .
  • If VT is tolerated hemodynamically (blood pressure and perfusion of organs is maintained), drug therapy is given (DC cardioversion not required)
  • – Lidocaine
  • Disopyramide
  • Beta blockers
  • Procainamide
  • Flecainide


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