Ventricular Tachycardia

Is it time to see a heart rhythm specialist?

What Is Ventricular Tachycardia (V-tach)?

Ventricular tachycardia (ven-TRI-kyuh-lar tack-uh-CARD-ee-uh) is an arrhythmia (uh-RITH-mee-uh), which means an abnormal heartbeat. Ventricular tachycardia (also called V-tach) makes part of the heart beat the wrong way.

Your heart is made of four separate areas (chambers) that squeeze and release in a specific way to keep your blood moving through your body. The two upper chambers are called the atria (AY-tree-uh) and the lower chambers are called ventricles (VEN-tri-kulls). V-tach makes the lower chambers of the heart beat faster than normal. On average, a healthy heart beats about 60 to 100 times a minute. In a V-tach episode, the heart beats over 100 times a minute.

This fast heartbeat stops the heart chambers from properly filling with blood. As a result, the heart may not be able to pump enough blood to the body. If this happens, you may feel short of breath or lightheaded, or you may pass out.

V-tach episodes may be brief and last only a couple of seconds without causing harm. But episodes lasting more than a few seconds (sustained V-tach) can be life-threatening. Sometimes V-tach can cause the heart to stop (sudden cardiac arrest).

How Does V-tach Develop?

Your heart is a pump made of muscle tissue. The heart needs a source of energy and oxygen to function, like all muscles. The heart’s squeezing and releasing action is regulated by an electrical system that makes all the chambers of the heart work together. If these electrical signals are off or fire at the wrong time, it leads to problems such as V-tach.

Electrical signals are passed to and from small mounds of special tissue in the heart called nodes. There are two: the sinus and the atrioventricular node (ay-tree-oh-ven-TRI-kyuh-lar nohd), or the AV node. A healthy heart at rest beats about 60 to 100 times per minute as electrical signals move through the chambers of the heart.

The electrical signals in your heart are carefully timed so your heart can deliver oxygen to your body. Each squeeze, or contraction, of the ventricles represents one heartbeat. The atria contract before the ventricles to move blood into the ventricles, and then the ventricles contract.

If any part of this system doesn’t work, then the heart can’t work like it should. This results in shortness of breath, dizziness and many other problems such as ventricular tachycardia. V-tach happens when the lower two chambers of the heart beat too fast – sometimes up to 170 beats per minute.

How Serious Is Ventricular Tachycardia?

A healthy heart at rest beats about 60 to 100 times a minute. V-tach can make the heart beat very fast – close to 170 beats a minute. A heart rate of 170 can cause you to feel lightheaded or even cause you to pass out. Sometimes a V-tach episode is short and no harm is done. If an episode of V-tach continues for more than 30 seconds (called sustained V-tach), you can go into sudden cardiac arrest. This is when the heart stops beating, then breathing stops. Survival is possible with immediate medical attention.

V-tach can lead to ventricular fibrillation (fi-bruh-LAY-shun), which is when the lower chambers of the heart flutter instead of fully squeezing and pumping blood. This can also lead to cardiac arrest. Survival is possible if someone performs cardiopulmonary resuscitation (CPR) or uses a defibrillator (de-FI-bruh-lay-tor), which sends an electrical signal to restart the heart.

Left untreated, V-tach can lead to frequent fainting, heart failure or cardiac arrest. Patients with V-tach are usually at a higher risk of heart conditions, which can be fatal. Irregular heart rhythms like V-tach or ventricular fibrillation – if left untreated – can have a high risk of death of about 20% within two years.

There are factors that affect your life expectancy if you have V-tach, including:

  • Conditions that put a strain on the heart or damages heart tissue
  • Heart disease
  • Medication side effects
  • Severe electrolyte imbalances
  • Use of stimulant drugs such as cocaine or methamphetamine
  • Lifestyle factors such as smoking, obesity and activity levels

A family history of tachycardia or other heart rhythm disorders makes a person more likely to develop V-tach.

Symptoms of V-tach

Short episodes of V-tach are usually harmless, but prolonged or repeated episodes can mean something more serious. Typical V-tach symptoms include:

  • A heart rate of 170 beats per minute or more
  • Chest pain or a feeling of pressure in the chest
  • Dizziness or lightheadedness
  • Shortness of breath or hard time catching your breath
  • Fainting or loss of consciousness

What Causes V-tach?

V-tach is when the electrical signals in your heart are not working as they should. V-tach causes include:

  • Having a heart attack or other heart condition that caused scarring of heart tissue (structural heart disease). There are several conditions that fall in this category including myocarditis (inflammation around the heart), cardiomyopathy and heart valve disease
  • Poor blood flow to the heart muscle due to coronary artery disease
  • Congenital heart diseases, which means a heart condition you are born with
  • Imbalance of electrolytes, which are substances that help the heart’s electrical system work — such as potassium, sodium, calcium and magnesium
  • Side effects of medication
  • Use of stimulants such as cocaine or methamphetamine

Sometimes, there is no known cause for V-tach. This is called idiopathic (id-ee-oh-PATH-ick) V-tach. That means there is no obvious reason for the irregular heartbeat – you haven’t had any of the conditions listed above, there is no scarring, etc.         

Does Heart Failure Cause V-tach?

Heart failure develops when the heart, for some reason, isn’t pumping enough blood or isn’t pumping fast enough to keep up with the body’s needs. It doesn’t mean the heart stops, like cardiac arrest. The heart isn’t able to do its job well enough. A symptom of heart failure is sometimes V-tach. V-tach can lead to sudden cardiac arrest.

If you notice your heart is missing a beat or beating too quickly when you’re not active, if you have symptoms such as fainting, dizziness or lightheadedness, or you have a family history of heart arrhythmias, talk to your doctor. There are medications and procedures that can help, but earlier diagnosis is better.

Treatment for V-tach

Your doctor may try medications to treat V-tach. These medications are called anti-arrhythmics. They can be given in a pill form or by a needle in your arm that slowly drips the medicine into your body. Other medicines can also be used, alone or with anti-arrythmics. Calcium channel blockers and beta blockers are two commonly used drugs for V-tach. These drugs slow the heart rate and reduce blood pressure.

V-tach can be treated with medication, but there are some reasons why a ventricular catheter ablation might be right for you. You will talk to an electrophysiologist (eh-LEK-troh-fi-zee-AHLL-oh-just), who has an expertise in understanding your heart’s electrical signals. Before recommending ablation, the doctor will check:

  • If your V-tach cannot be treated well with medication
  • How well medication works for you
  • If you have or have had heart failure
  • If you have reduced ejection fraction (low EF), which is the amount of blood the lower left chamber (ventricle) of your heart pushes out with each heartbeat

Your physician may also take into consideration your age.

If you have a device that sends electrical signals to your heart to get it to beat correctly, called an implantable cardioverter-defibrillator, ablation can reduce the number of times this device needs to send a signal to your heart to get it to beat correctly.

The ablation procedure typically has a higher success rate than medication alone, which means there is less risk of symptoms returning. There is a low risk of complications with this procedure, as well as a quick recovery time.

Treatment for V-tach involves managing any diseases that causes the condition, as well as the symptoms of V-tach. Common treatments for V-tach include:

  • Radiofrequency catheter ablation (RCA): After locating the point where an abnormal rhythm starts in the heart, your physician will destroy tissue in that area with an electrical current.
  • Implantable cardioverter-defibrillator (ICD): This small machine monitors and controls your heart’s rhythm. A battery is inserted below the collarbone, usually on the left side just underneath the skin. It is connected to leads, which are passed through the blood vessel to the heart. If the ICD detects an episode of ventricular tachycardia, it quickly sends an electrical signal to get your heart back to a normal rhythm.
  • Medications: These can slow heart rate and may help your heart to maintain a safe rhythm. Your health care provider can help you understand the pros and cons of medications.

If you or a loved one has recurring episodes of V-tach, and you have not seen a health care provider, make an appointment soon.

Heart and Vascular Care for the Whole Person

Norton Heart & Vascular Institute offers patient resources to support you and your family, including free classes for people of all ages who are seeking to improve cardiovascular health or living with a heart condition.

Cardiac Rehabilitation Program

Our cardiac rehabilitation providers are leaders in developing and applying innovative techniques that can help you recover and resume your life.

Connecting Hearts Support Group

The group provides education and support to individuals who have had a heart attack, are living with a heart condition or are at risk for cardiovascular disease.

Heart Health Screenings

Prevention is the best way to manage heart disease, and screenings are available to detect early signs of cardiac and vascular disease and identify risk factors.

About Norton Heart & Vascular Institute

Every year, more than 137,000 people in Louisville and Southern Indiana choose Norton Heart & Vascular Institute specialists for their heart and vascular care. That’s more than any other health care provider.

  • Norton Healthcare’s adult-service hospitals in Louisville all have received Chest Pain Center accreditation from the American College of Cardiology (ACC). This is the seventh consecutive accreditation for all four hospitals, which ensures quality for the treatment of heart attack.
  • Norton Audubon Hospital, Norton Brownsboro Hospital and Norton Hospital all are recognized as having ACC Chest Pain Center with Primary PCI accreditation.
  • Norton Healthcare has the most facilities across the city of Louisville with the ability treat a life-threatening heart attack.
  • You have access to more than 100 physicians and advanced practice providers with specialized training and experience in a comprehensive range of conditions and treatments.
  • Patients can make appointments at 28 locations in Louisville and Southern Indiana. Telecardiology is offered at more than 30 sites in the region.
  • Norton Audubon Hospital, a key location for Norton Heart & Vascular Institute services, has been recognized with a HeartCare Center National Distinction of Excellence year after year by the American College of Cardiology. This is the only hospital in Louisville to be recognized for this distinction.
  • U.S. News & World Report 2023-24 Best Hospitals ranked Norton Healthcare’s adult-service hospitals in Louisville as high performing in heart attack, heart failure, aortic valve surgery and heart bypass surgery.
  • Norton Audubon Hospital earned ventricular assist device (VAD) accreditation from DNV – Healthcare and the Centers for Medicare & Medicaid Services.
  • Communicate with your health care provider, renew prescriptions, get lab results and more through your free Norton MyChart account.

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