Wide complex tachycardia (patient information): Difference between revisions
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'''For the WikiDoc page for this topic, click [[Wide complex tachycardia|here]]''' | '''For the WikiDoc page for this topic, click [[Wide complex tachycardia|here]]''' | ||
{{SK}} WCT; fast and wide; wide and fast; wide-complex tachycardia; wide complex rhythm; SVT with aberrancy; SVT with aberrant conduction; supraventricular tachycardia with aberrancy; VT versus SVT | |||
==Overview== | ==Overview== | ||
A wide complex tachycardia is a rapid heart rate. In approximately 80% of cases, wide complex tachycardia is due to [[ventricular tachycardia]] ([[VT]]), a rapid heartbeat that starts in the ventricles. This page focuses on ventricular tachycardia as a cause of wide complex tachycardia. | |||
==What are the symptoms?== | |||
If the heart rate during a ventricular tachycardia episode is very fast or lasts longer than a few seconds. There may be symptoms such as: | |||
== | *Chest discomfort ([[angina]]) | ||
*Fainting ([[syncope]]) | |||
*Light-headedness or dizziness | |||
*Sensation of feeling the heart beat ([[palpitations]]) | |||
*Shortness of breath | |||
Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms. | |||
==What are the causes?== | |||
Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row. | Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row. | ||
The condition can develop as an early or late complication of a heart attack. It may also occur in patients with: | The condition can develop as an early or late complication of a [[heart attack]]. It may also occur in patients with: | ||
*Cardiomyopathy | *[[Cardiomyopathy]] | ||
*Heart failure | *[[Heart failure]] | ||
*Heart surgery | *Heart surgery | ||
*Myocarditis | *[[Myocarditis]] | ||
*Valvular heart disease | *[[Valvular heart disease]] | ||
Ventricular tachycardia can occur without heart disease. | Ventricular tachycardia can occur without heart disease. | ||
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*Lack of enough oxygen | *Lack of enough oxygen | ||
"Torsade de pointes" is a form of ventricular tachycardia that is often due to congenital heart disease or the use of certain medications | "[[Torsade de pointes]]" is a form of ventricular tachycardia that is often due to [[congenital heart disease]] or the use of certain medications. | ||
== | ==Diagnosis== | ||
Signs include: | Signs include: | ||
Absent pulse | *Absent pulse | ||
Loss of consciousness | *Loss of consciousness | ||
Normal or low blood pressure | *Normal or low [[blood pressure]] | ||
Rapid pulse | *Rapid pulse | ||
Ventricular tachycardia may be seen on: | Ventricular tachycardia may be seen on: | ||
Continuous ambulatory electrocardiogram (Holter monitor) | *Continuous ambulatory electrocardiogram (Holter monitor) | ||
ECG | *ECG | ||
Intracardiac electrophysiology study (EPS) | *Intracardiac electrophysiology study (EPS) | ||
Loop recorder | *Loop recorder | ||
Blood chemistries and other tests may be done. | Blood chemistries and other tests may be done. | ||
==Treatment== | ==Treatment options== | ||
Treatment depends on the symptoms, and the type of heart disorder. Some people may not need treatment. | Treatment depends on the symptoms, and the type of heart disorder. Some people may not need treatment. | ||
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If ventricular tachycardia becomes an emergency situation, it may require: | If ventricular tachycardia becomes an emergency situation, it may require: | ||
CPR | *CPR | ||
Electrical defibrillation or cardioversion (electric shock) | *Electrical defibrillation or [[cardioversion]] (electric shock) | ||
Anti-arrhythmic medications (such as lidocaine, procainamide, sotalol, or amiodarone) given through a vein | *Anti-arrhythmic medications (such as [[lidocaine]], [[procainamide]], [[sotalol]], or [[amiodarone]]) given through a vein | ||
Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as procainamide, amiodarone, or sotalol). However, anti-arrhythmic medications may have severe side effects. Their use is decreasing in favor of other treatments. | Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as [[procainamide]], [[amiodarone]], or [[sotalol]]). However, anti-arrhythmic medications may have severe side effects. Their use is decreasing in favor of other treatments. | ||
Some ventricular tachycardias may be treated with an ablation procedure. Radiofrequency catheter ablation can cure certain tachycardias. | Some ventricular tachycardias may be treated with an ablation procedure. Radiofrequency catheter ablation can cure certain tachycardias. | ||
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The doctor programs the ICD to sense when ventricular tachycardia is occurring, and to administer a shock to stop it. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia. You may need to take anti-arrhythmic drugs to prevent repeated firing of the ICD. | The doctor programs the ICD to sense when ventricular tachycardia is occurring, and to administer a shock to stop it. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia. You may need to take anti-arrhythmic drugs to prevent repeated firing of the ICD. | ||
==Outlook (Prognosis)== | ==What to expect Outlook (Prognosis)?== | ||
The outcome depends on the heart condition and symptoms. | The outcome depends on the heart condition and symptoms. | ||
Latest revision as of 00:54, 5 August 2013
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Wide complex tachycardias (Patient information) |
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Wide complex tachycardias On the Web |
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Risk calculators and risk factors for Wide complex tachycardias |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
For the WikiDoc page for this topic, click here
Synonyms and keywords: WCT; fast and wide; wide and fast; wide-complex tachycardia; wide complex rhythm; SVT with aberrancy; SVT with aberrant conduction; supraventricular tachycardia with aberrancy; VT versus SVT
Overview
A wide complex tachycardia is a rapid heart rate. In approximately 80% of cases, wide complex tachycardia is due to ventricular tachycardia (VT), a rapid heartbeat that starts in the ventricles. This page focuses on ventricular tachycardia as a cause of wide complex tachycardia.
What are the symptoms?
If the heart rate during a ventricular tachycardia episode is very fast or lasts longer than a few seconds. There may be symptoms such as:
- Chest discomfort (angina)
- Fainting (syncope)
- Light-headedness or dizziness
- Sensation of feeling the heart beat (palpitations)
- Shortness of breath
Note: Symptoms may start and stop suddenly. In some cases, there are no symptoms.
What are the causes?
Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least three irregular heartbeats in a row.
The condition can develop as an early or late complication of a heart attack. It may also occur in patients with:
- Cardiomyopathy
- Heart failure
- Heart surgery
- Myocarditis
- Valvular heart disease
Ventricular tachycardia can occur without heart disease.
Scar tissue may form in the muscle of the ventricles days, months, or years after a heart attack. This can lead to ventricular tachycardia.
Ventricular tachycardia can also be caused by:
- Anti-arrhythmic medications
- Changes in blood chemistry (such as a low potassium level)
- Changes in pH (acid-base)
- Lack of enough oxygen
"Torsade de pointes" is a form of ventricular tachycardia that is often due to congenital heart disease or the use of certain medications.
Diagnosis
Signs include:
- Absent pulse
- Loss of consciousness
- Normal or low blood pressure
- Rapid pulse
Ventricular tachycardia may be seen on:
- Continuous ambulatory electrocardiogram (Holter monitor)
- ECG
- Intracardiac electrophysiology study (EPS)
- Loop recorder
Blood chemistries and other tests may be done.
Treatment options
Treatment depends on the symptoms, and the type of heart disorder. Some people may not need treatment.
If ventricular tachycardia becomes an emergency situation, it may require:
- CPR
- Electrical defibrillation or cardioversion (electric shock)
- Anti-arrhythmic medications (such as lidocaine, procainamide, sotalol, or amiodarone) given through a vein
Long-term treatment of ventricular tachycardia may require the use of oral anti-arrhythmic medications (such as procainamide, amiodarone, or sotalol). However, anti-arrhythmic medications may have severe side effects. Their use is decreasing in favor of other treatments.
Some ventricular tachycardias may be treated with an ablation procedure. Radiofrequency catheter ablation can cure certain tachycardias.
A preferred treatment for many chronic (long-term) ventricular tachycardias consists of implanting a device called implantable cardioverter defibrillator (ICD). The ICD is usually implanted in the chest, like a pacemaker. It is connected to the heart with wires.
The doctor programs the ICD to sense when ventricular tachycardia is occurring, and to administer a shock to stop it. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia. You may need to take anti-arrhythmic drugs to prevent repeated firing of the ICD.
What to expect Outlook (Prognosis)?
The outcome depends on the heart condition and symptoms.
Possible Complications
Ventricular tachycardia may not cause symptoms in some people. However, it may be lethal in other people. It is a major cause of sudden cardiac death.
Prevention
In some cases, the disorder is not preventable. In other cases, it can be prevented by treating heart diseases and correcting blood chemistries.