What is Ventricular Tachycardia?

Ventricular Tachycardia is a fast, abnormal heart rhythm caused by electrical signals from the lower chambers of the heart or ventricles. It can last a few seconds at a time for only a few beats (nonsustained VT) or can be prolonged (sustained VT) and life threatening. Ventricular tachycardia is uncommon in children.

VT can occur in normally structured hearts and can occur when there is scarring of the walls of the ventricle due to previous damage or past heart conditions. It is also seen in those with certain genetic conditions that cause abnormal heart rhythms (inherited arrhythmias) such as Long QT Syndrome (LQTS), Brugada Syndrome (BrS) or Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). VT is also seen in certain abnormal heart muscle conditions such as Arrhythmogenic Cardiomyopathy (ACM).

Effects and Symptoms

VT causes an abnormally rapid squeezing of the lower chambers that is not coordinated with the upper chambers of the heart. As a result, the heart does not pump enough blood to the brain and body. Children with VT can experience palpitations, dizziness, light-headedness or fainting during episodes. When a VT is prolonged or sustained, it can affect the blood pressure and result in sudden cardiac arrest.

Diagnosis

An ECG or a recording of the heart rhythm is needed to diagnose VT. In cases where there is high suspicion for a possible inherited arrhythmia, a Holter monitor, event recorder, loop recorder or exercise stress tests can be performed to capture VT episodes.

Management and Treatment

The cause of VT should be investigated. Nonsustained episodes of VT are not life-threatening but are treated when they occur frequently and cause symptoms. Treatment will depend on what causes the VT. You will need to discuss with your physician which of these treatment options is appropriate for you:

1. Medications:  There are medications available to help reduce the number of episodes of VT. 
2. Radiofrequency Catheter Ablation:  Some types of VT may be treated with catheter ablation. This procedure is done in the heart catheterization lab and delivers energy in a very specific way to destroy (“ablate”) the abnormal cells or pathways causing your VT.
3. Not treating VT is an option if the episodes are infrequent, don’t last very long, and cause few symptoms. Regular monitoring will be needed to see if any changes develop that would lead us to start treatment.
4. Patients with sustained or life-threatening VT episodes or those who have a condition with a high risk of life-threatening or progressive VT are advised to have an implantable cardiac defibrillator (ICD). An ICD is a device implanted in the chest that can detect and stop VT when it occurs. This procedure, while potentially life-saving, carries risks and complications as well. Cases are managed on an individual basis. Careful assessment and family discussion are needed in the evaluation of these procedures.