Ventricular tachycardia natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Aditya Ganti M.B.B.S. [3]
Overview
Ventricular arrhythmia may include the range from triple premature ventricular contraction s (PVCs) to ventricular fibrillation. Clinical presentation varies from asymptomatic to cardiac arrest. Ventricular tachycardia can cause life-threatening or fatal hemodynamic compromise or it can degenerate into a life-threatening rhythm called ventricular fibrillation. Common complications of ventricular tachycardia include sudden cardiac death, cardiomyopathy, ventricular fibrillation, and infection related to ICD. The prognosis of ventricular tachycardia in patients largely depends upon the presence and severity of underlying cardiac disease. Mortality of ventricular tachycardia is higher in patients with coronary artery disease and presence of LV dysfunction. Prognosis is generally good in patients with right ventricular dysplasia, idiopathic ventricular tachycardia or ventricular fibrillation treated medically. Contrary to previous studies, VT or VF at any time after STEMI was associated with higher mortality rate within 90 days. Late VT or VF (after 48 hours of hospital admission) after STEMI was associated with a higher risk of death than early VT or VF (within 48 hours of hospital admission).
Natural History
- Ventricular arrhythmia may include the range from triple premature ventricular contraction s (PVCs) to ventricular fibrillation.
- Clinical presentation varies from asymptomatic to cardiac arrest.
- Ventricular tachycardia can cause life-threatening or fatal hemodynamic compromise or it can degenerate into a life-threatening rhythm called ventricular fibrillation. In general, supraventricular tachycardia with aberrancy is generally better tolerated and is not necessarily a medical emergency. An exception is if the the wide complex tachycardia is due to atrial fibrillation conducting down a bypass track such as is seen in Wolff-Parkinson-White syndrome (WPW) in which case the rhythm can degenerate into life-threatening ventricular fibrillation.
Complications
Common complications of ventricular tachycardia include:
- Ventricular fibrillation
- Sudden cardiac death
- Cardiomyopathy
- Infection related to implantable cardioverter defibrillator[1]
Prognosis
- Mortality of ventricular tachycardia is higher in patients with coronary artery disease and LV dysfunction.[2]
- Prognosis is generally good in patients with right ventricular dysplasia, idiopathic ventricular tachycardia or ventricular fibrillation treated medically.
- Contrary to previous studies, VT or VF at any time after STEMI was associated with higher mortality rate within 90 days.
- Late VT or VF (after 48 hours of hospital admission) after STEMI was associated with a higher risk of death than early VT or VF (within 48 hours of hospital admission).[3]
References
- ↑ Peichl P, Wichterle D, Pavlu L, Cihak R, Aldhoon B, Kautzner J (August 2014). "Complications of catheter ablation of ventricular tachycardia: a single-center experience". Circ Arrhythm Electrophysiol. 7 (4): 684–90. doi:10.1161/CIRCEP.114.001530. PMID 24958396.
- ↑ Trappe HJ, Brugada P, Talajic M, Della Bella P, Lezaun R, Mulleneers R, Wellens HJ (July 1988). "Prognosis of patients with ventricular tachycardia and ventricular fibrillation: role of the underlying etiology". J. Am. Coll. Cardiol. 12 (1): 166–74. doi:10.1016/0735-1097(88)90370-1. PMID 3379202.
- ↑ Volpi A, Cavalli A, Franzosi MG, Maggioni A, Mauri F, Santoro E, Tognoni G (May 1989). "One-year prognosis of primary ventricular fibrillation complicating acute myocardial infarction. The GISSI (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto miocardico) investigators". Am J Cardiol. 63 (17): 1174–8. doi:10.1016/0002-9149(89)90174-4. PMID 2565684.