Ventricular tachycardia diagnostic study of choice
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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
Simple ECG is the first initiative study of choice for diagnosing a ventricular tachycardia rhythm. Further investigations are necessary afterwards to confirm the cause of abnormal ventricular rhythm. Cardiac magnetic resonance is the gold standard test for the diagnosis of structural VT substrate. Cardiac magnetic resonance provides detailed assessment of cardiac morphology and function.
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 QRStachycardia, 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.