Right ventricular outflow tract tachycardia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: RVOT tachycardia; right ventricular outflow tract VT; right ventricular outflow tract ventricular tachycardia; right ventricular outflow tract (RVOT) tachycardia

Overview

RVOT tachycardia is a type of monomorphic ventricular tachycardia originating in the right ventricular outflow tract. RVOT morphology refers to the characteristic pattern of this type of tachycardia on an ECG.

Pathophysiology

RVOT tachycardia is a type of monomorphic VT that originates from either the outflow tract of the right ventricle (the right ventricular outflow tract) or in some cases from the tricuspid valve annulus.

Associated Conditions

Uusally structural heart disease is absent, but RVOT tachycardia can occur in the context of arrhythmogenic right ventricular dysplasia (ARVD). Left to right shunts can be associated with RVOT tachycardia as can right sided valvular lesions.

Natural History, Complications, Prognosis

RVOT tachycardia is generally not associated with sudden cardiac death.

Diagnosis

Physical Examination

In so far as structural heart disease is absent, there are no physical examination findings.

Electrocardiogram

Electrocardiographic characteristics include the following:

• Atrioventricular dissociation similar to all patients with VT
• Heart rate > 100 beats per minute
• QRS duration > 120 milliseconds
• Left bundle branch block pattern or morphology with negative deflection in V1 and V2
• A rightward and inferior axis deviation (approximately +90 degrees)

Lecture

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