Ventricular tachycardia echocardiography: Difference between revisions

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{{Ventricular tachycardia}}
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==Overview==
==Overview==
[[Echocardiography]] can be performed in the patient with ventricular tachycardia to rule out structural abnormalities such as a [[right ventricle|right ventricular]] [[cardiomyopathy]] and silent [[ischemia]] on [[stress testing]]. [[Coronary arteriography]] is often performed in the patient with ventricular tachycardia to rule out obstructive [[coronary artery disease]].
[[Echocardiography]] is an available and helpful modality for [[diagnosis]] and predicting the underlying causes of [[ventricular tachycardia]] and [[sudden cardiac arrest]]. Findings on an [[echocardiography]] include  assessment of [[myocardial]] function, [[valvular]] structural and functional disease, [[congenital heart disease]], [[cardiomyopathy]], [[heart failure]], prior [[MI]].


== ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (DO NOT EDIT) <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref> ==
== Echocardiography ==
[[Echocardiography]] is an available and helpful modality for [[diagnosis]] and predicting the underlying causes of [[ventricular tachycardia]] and [[sudden cardiac arrest]]. Findings on an [[echocardiography]] include:
* Global and regional [[myocardial]] function
* Assessment of [[valvular]] structural and functional disease
* Evaluation of [[congenital heart disease]]
* Determination of [[Cardiomyopathy]], [[heart failure]], prior [[MI]]<ref name="SolomonZelenkofske2005">{{cite journal|last1=Solomon|first1=Scott D.|last2=Zelenkofske|first2=Steve|last3=McMurray|first3=John J.V.|last4=Finn|first4=Peter V.|last5=Velazquez|first5=Eric|last6=Ertl|first6=George|last7=Harsanyi|first7=Adam|last8=Rouleau|first8=Jean L.|last9=Maggioni|first9=Aldo|last10=Kober|first10=Lars|last11=White|first11=Harvey|last12=Van de Werf|first12=Frans|last13=Pieper|first13=Karen|last14=Califf|first14=Robert M.|last15=Pfeffer|first15=Marc A.|title=Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both|journal=New England Journal of Medicine|volume=352|issue=25|year=2005|pages=2581–2588|issn=0028-4793|doi=10.1056/NEJMoa043938}}</ref>


=== Left Ventricular Function and Imaging (DO NOT EDIT) <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995}}</ref> ===
* [[LVEF]] evaluation as the strong predictor of [[SCD]] and [[mortality]]
:* There is no difference between modalities ([[echocardiography]], [[radionuclide angiography]], contrast [[angiograms]]) for evaluation of [[LVEF]] and determining the [[ICD]] implantation.<ref name="GulaKlein2008">{{cite journal|last1=Gula|first1=Lorne J.|last2=Klein|first2=George J.|last3=Hellkamp|first3=Anne S.|last4=Massel|first4=David|last5=Krahn|first5=Andrew D.|last6=Skanes|first6=Allan C.|last7=Yee|first7=Raymond|last8=Anderson|first8=Jill|last9=Johnson|first9=George W.|last10=Poole|first10=Jeanne E.|last11=Mark|first11=Daniel B.|last12=Lee|first12=Kerry L.|last13=Bardy|first13=Gust H.|title=Ejection fraction assessment and survival: An analysis of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)|journal=American Heart Journal|volume=156|issue=6|year=2008|pages=1196–1200|issn=00028703|doi=10.1016/j.ahj.2008.08.007}}</ref>


==2017 ACC/AHA/HRS Guideline for management of [[ventricular tachycardia]]==
<ref name="Al-KhatibStevenson2018">{{cite journal|last1=Al-Khatib|first1=Sana M.|last2=Stevenson|first2=William G.|last3=Ackerman|first3=Michael J.|last4=Bryant|first4=William J.|last5=Callans|first5=David J.|last6=Curtis|first6=Anne B.|last7=Deal|first7=Barbara J.|last8=Dickfeld|first8=Timm|last9=Field|first9=Michael E.|last10=Fonarow|first10=Gregg C.|last11=Gillis|first11=Anne M.|last12=Granger|first12=Christopher B.|last13=Hammill|first13=Stephen C.|last14=Hlatky|first14=Mark A.|last15=Joglar|first15=José A.|last16=Kay|first16=G. Neal|last17=Matlock|first17=Daniel D.|last18=Myerburg|first18=Robert J.|last19=Page|first19=Richard L.|title=2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death|journal=Circulation|volume=138|issue=13|year=2018|issn=0009-7322|doi=10.1161/CIR.0000000000000549}}</ref>
{| class="wikitable"
{| class="wikitable"
|-
|-
| Colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| Colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|-
| Bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] is recommended in patients with [[ventricular arrhythmias]] who are suspected of having structural heart disease. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki>
| Bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[Echocardiography]] is recommended in patients with [[ventricular arrhythmias]] who are suspected of having [[structural heart disease]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>''
|-
|-
| Bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Echocardiography]] is recommended for the subset of patients at high risk for the development of serious [[ventricular arrhythmias]] or [[SCD]], such as those with dilated, hypertrophic, or [[RV]] [[cardiomyopathy|cardiomyopathies]], AMI survivors, or relatives of patients with inherited disorders associated with [[SCD]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki>
|-
| Bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Exercise testing with an imaging modality (echocardiography or nuclear perfusion single-photon emission computed tomography ([[SPECT]])) is recommended to detect silent ischemia in patients with ventricular arrhythmias who have an intermediate probability of having CHD by age, symptoms, and gender and in whom [[ECG]] assessment is less reliable because of [[digoxin]] use, [[LVH]], greater than 1-mm [[ST segment depression]] at rest, [[WPW syndrome]], or [[LBBB]]. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki>
|-
| Bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' Pharmacological stress testing with an imaging modality ([[echocardiography]] or [[myocardial perfusion]] ([[SPECT]])) is recommended to detect silent [[ischemia]] in patients with [[ventricular arrhythmias]] who have an intermediate probability of having [[CHD]] by age, symptoms, and gender and are physically unable to perform a symptom limited exercise test. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki>
|}


{| class="wikitable"
|-
| Colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' [[MRI]], cardiac computed tomography ([[CT]]), or [[radionuclide angiography]] can be useful in patients with [[ventricular arrhythmias]] when [[echocardiography]] does not provide accurate assessment of [[LV]] and [[RV]] function and/or evaluation of structural changes. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level B]])<nowiki>"</nowiki>
|-
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' [[Coronary angiography]] can be useful in establishing or excluding the presence of significant obstructive [[CHD]] in patients with life-threatening [[ventricular arrhythmias]] or in survivors of [[SCD]], who have an intermediate or greater probability of having [[CHD]] by age, symptoms, and gender. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki>
|-
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' [[LV]] imaging can be useful in patients undergoing biventricular pacing. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level C]])<nowiki>"</nowiki>
|}
|}


==Guidelines Resources==
*ACC / AHA 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death <ref name="pmid16935995">{{cite journal| author=Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M et al.| title=ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. | journal=Circulation | year= 2006 | volume= 114 | issue= 10 | pages= e385-484 | pmid=16935995 | doi=10.1161/CIRCULATIONAHA.106.178233 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16935995  }} </ref>
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]

Latest revision as of 07:51, 27 May 2021

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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

Echocardiography is an available and helpful modality for diagnosis and predicting the underlying causes of ventricular tachycardia and sudden cardiac arrest. Findings on an echocardiography include assessment of myocardial function, valvular structural and functional disease, congenital heart disease, cardiomyopathy, heart failure, prior MI.

Echocardiography

Echocardiography is an available and helpful modality for diagnosis and predicting the underlying causes of ventricular tachycardia and sudden cardiac arrest. Findings on an echocardiography include:


2017 ACC/AHA/HRS Guideline for management of ventricular tachycardia

[3]

Class I
"1. Echocardiography is recommended in patients with ventricular arrhythmias who are suspected of having structural heart disease. (Level of Evidence B)"

References

  1. ↑ Solomon, Scott D.; Zelenkofske, Steve; McMurray, John J.V.; Finn, Peter V.; Velazquez, Eric; Ertl, George; Harsanyi, Adam; Rouleau, Jean L.; Maggioni, Aldo; Kober, Lars; White, Harvey; Van de Werf, Frans; Pieper, Karen; Califf, Robert M.; Pfeffer, Marc A. (2005). "Sudden Death in Patients with Myocardial Infarction and Left Ventricular Dysfunction, Heart Failure, or Both". New England Journal of Medicine. 352 (25): 2581–2588. doi:10.1056/NEJMoa043938. ISSN 0028-4793.
  2. ↑ Gula, Lorne J.; Klein, George J.; Hellkamp, Anne S.; Massel, David; Krahn, Andrew D.; Skanes, Allan C.; Yee, Raymond; Anderson, Jill; Johnson, George W.; Poole, Jeanne E.; Mark, Daniel B.; Lee, Kerry L.; Bardy, Gust H. (2008). "Ejection fraction assessment and survival: An analysis of the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT)". American Heart Journal. 156 (6): 1196–1200. doi:10.1016/j.ahj.2008.08.007. ISSN 0002-8703.
  3. ↑ Al-Khatib, Sana M.; Stevenson, William G.; Ackerman, Michael J.; Bryant, William J.; Callans, David J.; Curtis, Anne B.; Deal, Barbara J.; Dickfeld, Timm; Field, Michael E.; Fonarow, Gregg C.; Gillis, Anne M.; Granger, Christopher B.; Hammill, Stephen C.; Hlatky, Mark A.; Joglar, José A.; Kay, G. Neal; Matlock, Daniel D.; Myerburg, Robert J.; Page, Richard L. (2018). "2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death". Circulation. 138 (13). doi:10.1161/CIR.0000000000000549. ISSN 0009-7322.
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