Pulseless ventricular tachycardia classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aisha Adigun, B.Sc., M.D.[2]

Overview

Pulseless ventricular tachycardia may as a ventricular tachycardia be classified based on the morphology of the QRS complexes into two subtypes/groups: monomorphic ventricular tachycardia, and polymorphic ventricular tachycardia

Classification

Based on the morphology of the QRS complexes, ventricular tachycardia can be grouped into two types:

Monomorphic ventricular tachycaridia

  • In monomorphic ventricular tachycardia the more common form, the rhythm originates from a single focus within the ventricles and the QRS complexes within each lead are identical. This form of ventricular tachycardia is most commonly seen in patients with underlying structural heart diseases.
12 lead electrocardiogram showing a run of monomorphic ventricular tachycardia (VT)
12 lead electrocardiogram showing a run of monomorphic ventricular tachycardia (VT)

Polymorphic ventricular tachycardia

  • In polymorphic ventricular tachycardia, there are multiple ventricular foci with the resultant QRS complexes varying from beat-to-beat. Torsade de Pointes is the most common form of polymorphic ventricular tachycardia and appears as a cyclical progressive change in the cardiac axis. The most common cause of polymorphic ventricular tachycardia is myocardial ischemia.
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