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: Aditya Ganti M.B.B.S. [2]
Overview
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. Common complications of ventricular tachycardia include sudden cardiac death, cardiomyopathy, ventricular fibrillation, and infection related to ICD. Prognosis of ventricular tachycardia in patients largely depends upon the presence and severity of underlying cardiac disease.
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.
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
Additional Sentences
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
Complications
Common complications of ventricular tachycardia include:[1]
- Sudden cardiac death
- Cardiomyopathy
- Infection related to implantable cardioverter defibrillator
- Ventricular fibrillation
Prognosis
- Mortality of ventricular tachycardia is higher in patients with coronary artery disease and LV dysfunction.[2][3]
- Prognosis is generally good in patients with right ventricular dysplasia, idiopathic ventricular tachycardia or ventricular fibrillation treated medically.
- Meanwhile, patients with underlying cardiac pathology may require lifelong medical therapy with medications, catheter ablation, and/or implantable cardioverter defibrillator (ICD) placement.
- 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).[4]
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, Hans-Joachim; Brugada, Pedro; Talajic, Mario; Bella, Paolo Della; Lezaun, Roman; Mulleneers, Rob; Wellens, Hein J.J. (1988). "Prognosis of patients with ventricular tachycardia and ventricular fibrillation: Role of the underlying etiology". Journal of the American College of Cardiology. 12 (1): 166–174. doi:10.1016/0735-1097(88)90370-1. ISSN 0735-1097.
- ↑ 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.