Ventricular tachycardia diagnostic study of choice: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Ventricular tachycardia}} | {{Ventricular tachycardia}} | ||
{{CMG}}; {{AE}} {{MIR}} | {{CMG}}; {{AE}} {{Sara.Zand}} {{MIR}} | ||
== Overview == | == Overview == | ||
[[ECG]] is the first diagnostic test that should be obtained in hemodynamically stable [[Ventricular tachycardia]]. For detection of [[tachyarrhythmia]] [[symptoms]] related exercise such as [[cathecolaminergic polymorphic VT]], [[Exercise stress test]] is recommended. Findings on resting [[ECG]] associated with diagnosis of [[VT]] include evidence of [[structural hear disease]] such as prior [[MI]] or [[chamber enlargement]], evidence of [[inherited arrhythmia disorders]] such as [[long QT syndrome]], [[Brugada syndrome]], [[arrhythmogenic right ventricular cardiomyopathy]]. [[QRS]] duration and [[conduction abnormality]] may have prognostic value in [[structural heart disease]]. | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
== 2017 AHA/ACC/HRS Guidelines for Management of [[Patients]] With [[Ventricular Arrhythmia]]s== | |||
{| class="wikitable" | |||
|- | |||
| Colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>In [[patients]] with sustained, hemodynamically stable, [[wide QRS tachycardia ]], 12 leads [[ECG]] should be obtained '' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>'' | |||
|- | |||
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>In [[patients]] with exercise induced [[ventricular tachyarrhythmia]] such as [[IHD]] or [[cathecolaminergic polymorphic VT]], exercise treadmill test is recommended'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>'' | |||
|- | |||
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki>In [[patients]] with suspected or documented [[VT]], 12 leads [[ECG]] during [[sinus rhythm]] should be obtained for detecting [[structural heart disease]]'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>'' | |||
|- | |||
| Bgcolor="LemonChiffon"|<nowiki>"</nowiki> [[Ambulatory electrocardiogram monitoring]] is recommended for [[patients]] presented with [[palpitation]], [[syncope]], [[presyncope]] suspected [[ventricular arrhythmia]]'' ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence B]])<nowiki>"</nowiki>'' | |||
|} | |||
* 12-lead [[ECG]] is the first diagnostic test that should be obtained in hemodynamically stable [[Ventricular tachycardia]]. | |||
* For detection of [[tachyarrhythmia]] [[symptoms]] related exercise such as [[cathecolaminergic polymorphic VT]], [[Exercise stress test]] is recommended. | |||
*Findings on [[ECG]] associated with [[VT]] include: | |||
# Evidence of [[structural hear disease]] such as prior [[MI]] or [[chamber enlargement]] | |||
# Evidence of [[inherited arrhythmia disorders]] such as [[long QT syndrome]], [[Brugada syndrome]], [[arrhythmogenic right ventricular cardiomyopathy]] | |||
*: [[QRS]] duration and [[conduction abnormality]] may have prognostic value in [[structural heart disease]].<ref name="BaldasseroniOpasich2002">{{cite journal|last1=Baldasseroni|first1=Samuele|last2=Opasich|first2=Cristina|last3=Gorini|first3=Marco|last4=Lucci|first4=Donata|last5=Marchionni|first5=Niccolò|last6=Marini|first6=Maurizio|last7=Campana|first7=Carlo|last8=Perini|first8=Giampaolo|last9=Deorsola|first9=Antonella|last10=Masotti|first10=Giulio|last11=Tavazzi|first11=Luigi|last12=Maggioni|first12=Aldo P.|title=Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure|journal=American Heart Journal|volume=143|issue=3|year=2002|pages=398–405|issn=00028703|doi=10.1067/mhj.2002.121264}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 05:31, 27 May 2021
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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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] Mahshid Mir, M.D. [3]
Overview
ECG is the first diagnostic test that should be obtained in hemodynamically stable Ventricular tachycardia. For detection of tachyarrhythmia symptoms related exercise such as cathecolaminergic polymorphic VT, Exercise stress test is recommended. Findings on resting ECG associated with diagnosis of VT include evidence of structural hear disease such as prior MI or chamber enlargement, evidence of inherited arrhythmia disorders such as long QT syndrome, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy. QRS duration and conduction abnormality may have prognostic value in structural heart disease.
Diagnostic Study of Choice
2017 AHA/ACC/HRS Guidelines for Management of Patients With Ventricular Arrhythmias
| Class I |
| "In patients with sustained, hemodynamically stable, wide QRS tachycardia , 12 leads ECG should be obtained (Level of Evidence B)" |
| "In patients with exercise induced ventricular tachyarrhythmia such as IHD or cathecolaminergic polymorphic VT, exercise treadmill test is recommended (Level of Evidence B)" |
| "In patients with suspected or documented VT, 12 leads ECG during sinus rhythm should be obtained for detecting structural heart disease (Level of Evidence B)" |
| " Ambulatory electrocardiogram monitoring is recommended for patients presented with palpitation, syncope, presyncope suspected ventricular arrhythmia (Level of Evidence B)" |
- 12-lead ECG is the first diagnostic test that should be obtained in hemodynamically stable Ventricular tachycardia.
- For detection of tachyarrhythmia symptoms related exercise such as cathecolaminergic polymorphic VT, Exercise stress test is recommended.
- Findings on ECG associated with VT include:
- Evidence of structural hear disease such as prior MI or chamber enlargement
- Evidence of inherited arrhythmia disorders such as long QT syndrome, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy
- QRS duration and conduction abnormality may have prognostic value in structural heart disease.[1]
References
- ↑ Baldasseroni, Samuele; Opasich, Cristina; Gorini, Marco; Lucci, Donata; Marchionni, Niccolò; Marini, Maurizio; Campana, Carlo; Perini, Giampaolo; Deorsola, Antonella; Masotti, Giulio; Tavazzi, Luigi; Maggioni, Aldo P. (2002). "Left bundle-branch block is associated with increased 1-year sudden and total mortality rate in 5517 outpatients with congestive heart failure: A report from the Italian network on congestive heart failure". American Heart Journal. 143 (3): 398–405. doi:10.1067/mhj.2002.121264. ISSN 0002-8703.