Acute management of ventricular tachycardia

AbstractAcute management of patients with ventricular arrhythmia (VA) is aimed at immediate VA termination if the patient is hemodynamically instable and early termination after initial diagnostic work-up if tolerated. Prolonged episodes of VA may lead to hemodynamic and metabolic decompensation and early resumption of normal ventricular activation is warranted. Termination is best performed by electrical cardioversion, anti-tachycardia pacing (if available, in cases with an implanted defibrillator [ICD]) or defibrillation. Antiarrhythmic drug treatment may lead to rhythm stabilization in cases of VA recurrence. Scrutinizing the electrocardiogram (ECG) of VA is extremely helpful to differentiate potential mechanisms, underlying cardiac pathologies and identify treatment options, as well as a differential diagnosis if a ventricular origin is unclear. In general, structural VA should be differentiated from idiopathic and non-structural (idiopathic) VA. On the other hand, based on ECG morphology VA should be classified into monomorphic versus polymorphic ventricular tacyhcardia (VT)/ventricular fibrillation (VF). Polymorphic VT/VF may be related to reversible causes as well as genetically determined arrhythmia syndromes and a  specialized treatment pathway may be chosen: (1) VA termination, (2) evaluation and treatment of potential VA causes, (3) acute (medical treatment) and chronic (interventional treatment using catheter ablation) prevention of recurrence ...
Source: Herzschrittmachertherapie und Elektrophysiologie - Category: Cardiology Source Type: research

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More News: Arrhythmia | Cardiology | Electrocardiogram | Genetics | Heart | Heart Disease | Heart Failure | Ventricular Arrhythmia | Ventricular Tachycardia