Ventricular tachycardia

Ventricular tachycardia (VT) is a broad complex tachycardia originating from a ventricular ectopic focus. It is defined as three or more ventricular extrasystoles in succession at a rate of more than 120 beats per minute (bpm). Accelerated idioventricular rhythm refers to ventricular rhythms with rates of 100-120 bpm

1. Dr Ramachandra
Ventricular
Tachycardia
“I do not know what I may appear to the
world, but to myself I seem to have been
only like a boy playing on the sea-shore, and
diverting myself in now and then finding a
smoother pebble or a prettier shell than
ordinary, whilst the great ocean of truth lay
all undiscovered before me.” 
― Isaac Newton

2. Define
Arrhythmia
HR≥100/min
 Originates in the ventricles
Wide QRS complexes (120 ms)

3. Types
Idiopathic vs. structural
Sustained (>30sec) vs. non sustained
Monomorphic vs. polymorphic(≥5 continuous QRS has no
clear isoelectric baseline)
With or without hemodynamic collapse

4. Diagnosis
ECG is enough
Wide QRS:80% VT
:20% SVT with aberrancy/AVRT/etc

5. VT Cousins

6. VT Cousins

7. concordance=Polarity
Negative: All QRS in V1-6 -VE
Positive: All QRS in V1-6 +VE

8. ECG

9. QRS in MI looks Spine or sternum?

10. Poor R-wave progression and VT

11. Where they came from?

12. Bundle branch reentry -VT

13. Idiopathic Monomorphic VT

14. Aortic cusp-VT

15. Medical Rx of VT

16. Amiodarone….Contid

17. Major ICD trials

18. Catheter ablation

19. LONG QT

20. Bidirectional VT

21. T-dP

22. Rx that cause Brugada ECG

23. Rx algorithm in Brugada

24. Brugada vs. EPRS

25. NSVT
Normal heart+NSVT=Rx to S/S/LVD
↓
NSVT burden ≥ 15%-20% of Holter= Drug+RFA
Old MI+NSVT=
1.EF≥40% -only symptomatic
2.EF=30-40% then EPS-then ICD
3.EF<30%-ICD

26. Success lies in detachment