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Ventricular tachycardia

Published by Bupa's health information team, June 2008.

This factsheet is for people who have ventricular tachycardia, or who would like information about it.

Ventricular tachycardia is a type of abnormal heartbeat (an arrhythmia) in which your heart beats too fast. If it lasts for longer than a few seconds, it may be life-threatening and you will need urgent medical attention.

Animation - The different types of arrhythmia
About ventricular tachycardia
Symptoms of ventricular tachycardia
Causes of ventricular tachycardia
Diagnosis of ventricular tachycardia
Treatment of ventricular tachycardia
Further information
Questions and answers
Related topics
Sources

The different types of arrthythmia

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About ventricular tachycardia

Your heart is a muscular pump, responsible for delivering blood to the rest of your body. Your heartbeat is produced by electrical impulses, which start in the upper chambers of your heart (the atria) and are transmitted to the lower chambers (the ventricles). The impulses cause your heart to contract and pump blood around the rest of your body.

In ventricular tachycardia, abnormal electrical impulses are produced in the lower chambers of the heart, which cause the heart to pump out blood quicker than normal. The ventricles may not have enough time to fill up properly with blood. You are more likely to get ventricular tachycardia if you have previously had a heart attack.

A normal heart rate is between 60 and 100 beats per minute. It is normal for your heart rate to vary depending on what you are doing, and everyone's heart sometimes beats faster. However in ventricular tachycardia, the heart rate increases to between 120 and 200 beats per minute.

The seriousness of the condition can vary, with some attacks lasting for just a few seconds, and others needing treatment in order to get the heartbeat back to normal. If the attack lasts for 30 seconds or more (sustained ventricular tachycardia), it can progress to a condition called ventricular fibrillation. This is extremely dangerous and can cause a cardiac arrest (when the heart stops beating).

Illustration showing the electrical impulses in a normal heart and a heart with ventricular tachycardia
The electrical impulses in a normal heart and a heart with ventricular tachycardia

Symptoms of ventricular tachycardia

When ventricular tachycardia causes a cardiac arrest, the person will lose their pulse and will quickly become unconscious and stop breathing.

Ventricular tachycardia can also cause the following symptoms:

fainting
extreme dizziness
chest pain
breathlessness
palpitations (where you become aware of your heart beating faster or more forcefully) - occasionally this may be the only symptom you get

If you suddenly start to feel breathless or have chest pain - or witness someone else collapse and lose consciousness, you should call for emergency help. If you have any other of these symptoms, such as fainting and dizziness, you should visit your GP.

Causes of ventricular tachycardia

You are more likely to develop ventricular tachycardia if you have had a problem with your heart, such as:

coronary heart disease
a heart attack
disease of the heart muscle
previous heart surgery
an inherited condition of the heart

However, you can also develop ventricular tachycardia even if you don't have any apparent problem with your heart. In this case it is usually a much less serious condition.

Diagnosis of ventricular tachycardia

Ventricular tachycardia is normally diagnosed with an electrocardiogram (ECG) test. An ECG is a test which measures the electrical activity of your heart to see how well it is working. An ECG will be carried out if you have had a heart attack or have suddenly become unwell with symptoms such as chest pain and fainting.

If you go to your GP because of symptoms such as palpitations or fainting episodes, he or she will ask about your symptoms and examine you. Your GP will also ask you about your medical history and may suggest you have an ECG. If you need further tests, your GP will refer you to a cardiologist - a doctor specialising in diseases of the heart.

Further tests

You may have the following tests to confirm whether you have ventricular tachycardia and what has caused it:

blood tests - these can show if you have had a heart attack, and can also be used to assess your kidney function and the level of salts (electrolytes) in your blood
an echocardiogram - this test uses ultrasound to produce a moving image of the inside of your heart
an angiogram - in this test, a dye visible on X-rays is injected into your coronary arteries to show up any narrowing or blockages
an ambulatory ECG - this records your heartbeat for 24 hours or more while you go about your normal daily activities
an electrophysiological study - this test uses electrode catheters inserted via a vein in the groin to stimulate the heart, allowing doctors to analyse your heart's electrical activity in greater detail than an ECG

Treatment of ventricular tachycardia

Treatment for ventricular tachycardia is aimed at stopping attacks if necessary, treating symptoms and preventing future attacks. If your ventricular tachycardia is not associated with heart disease and is not causing symptoms, you will probably not need any treatment at all.

A ventricular tachycardia attack can sometimes stop by itself. However, if the attack is sustained (lasts for longer than 30 seconds) you may need hospital treatment to stop it.

Emergency treatment

If you are having symptoms such as breathlessness, dizziness and chest pain, or are falling unconscious, it means that there may be an immediate risk of your condition getting worse and your heart going into ventricular fibrillation. This can be fatal. You will need to have an emergency procedure called an electrical cardioversion. In this procedure, a controlled electrical current is applied to your chest via a machine called a defibrillator, to help restore your heart to its normal rhythm. You will have a general anaesthetic before the procedure begins, so you will be asleep.

If you are having a sustained attack but are not having symptoms, you may be given a medicine (eg lidocaine) through a drip in your arm, in order to stop it.

Whichever type of treatment you have, you will also be given oxygen to help you breathe.

Medicines

The treatment you have long term will depend on your own individual circumstances, including how severe your attacks are and whether they are causing you symptoms.

Your doctor may prescribe you medicine to relieve your symptoms. These may include beta-blockers, which slow down your heart rate, and other anti-arrhythmic drugs, such as flecainide or amiodarone.

Surgery

If you are having frequent attacks and treatment with medicines is not helping your symptoms, you may be advised to have one of the following procedures.

An implantable cardioverter defibrillator (ICD) fitted. An ICD is a device that can monitor your heart rhythm and return your heartbeat to normal if it detects you are having a ventricular tachycardia attack. The device is implanted just beneath the skin below your collarbone and delivers a burst of extra beats or an electrical impulse (shock) via wires leading to your heart. The ICD is normally fitted under sedation and local anaesthetic. This means you will feel relaxed and will not be able to feel the ICD being fitted.
Catheter ablation. In this procedure, the abnormal areas of your heart are identified and destroyed. This is done using small tubes called electrode catheters, which are inserted into one of your veins or arteries, through a small puncture in the groin and threaded up to your heart. The catheter emits radio frequency energy, destroying the area that is causing the abnormal rhythm. The procedure is normally done under local anaesthetic. This blocks all feeling from the groin, so you will not feel the catheter being inserted - but you will stay awake during the procedure.

Before having either of these procedures, you will be given a chance to talk to your cardiologist and can ask him/her any questions you have.

Further information

Arrhythmia Alliance
01789 450787
www.heartrhythmcharity.org.uk
The British Heart Foundation
08450 70 80 70
www.bhf.org.uk