Ventricular tachycardia pathophysiology

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Ventricular tachycardia Microchapters


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]


The underlying mechanism of VT is due to automaticity arising in either the myocardium or in the distal conduction system. The most common underlying substrate for ventricular tachycardia is ischemic heart disease. Myocardial scarring from any process increases the likelihood of electrical reentrant circuits. These circuits generally include a zone where normal electrical propagation is slowed by the scar. Ventricular scar formation from a prior myocardial infarction (MI) is the most common cause of sustained monomorphic VT. The morphology of ventricular tachycardia often depends on its cause. VT in a structurally normal heart typically results from mechanisms such as triggered activity and enhanced automaticity. If VT is hemodynamically tolerated, the incessant tachyarrhythmia may cause a dilated cardiomyopathy. This may develop over a period of weeks to years and may resolve with successful suppression of the VT.


Pathophysiology of ventricular tachycardia can be better studied depending upon the subclass:[1][2][3][4]

Cellular level

Monomorphic Ventricular Tachycardia

Polymorphic Ventricular Tachycardia

Bundle Branch Re-entrant Ventricular Tachycardia

Accelerated idioventricular rhythm


  1. Martin CA, Lambiase PD (October 2017). "Pathophysiology, diagnosis and treatment of tachycardiomyopathy". Heart. 103 (19): 1543–1552. doi:10.1136/heartjnl-2016-310391. PMC 5629945. PMID 28855272.
  2. Simons GR, Klein GJ, Natale A (February 1997). "Ventricular tachycardia: pathophysiology and radiofrequency catheter ablation". Pacing Clin Electrophysiol. 20 (2 Pt 2): 534–51. doi:10.1111/j.1540-8159.1997.tb06209.x. PMID 9058854.
  3. Brunckhorst C, Delacretaz E (April 2004). "[Ventricular tachycardia--etiology, mechanisms and therapy]". Ther Umsch (in German). 61 (4): 257–64. doi:10.1024/0040-5930.61.4.257. PMID 15137521.
  4. Srivathsan K, Ng DW, Mookadam F (July 2009). "Ventricular tachycardia and ventricular fibrillation". Expert Rev Cardiovasc Ther. 7 (7): 801–9. doi:10.1586/erc.09.69. PMID 19589116.
  5. . doi:10.1001/jamaintern-med.2020.8999. Missing or empty |title= (help)

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