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Arrhythmias
 
 

Ventricular Tachycardia

 
 
 
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Overview

Monomorphic VT is a focal or reentrant ventricular rhythm that requires rapid assessment and management, due to its risk of haemodynamic instability and collapse.
  • Classification

  • Nonsustained VT - three or more ventricular beats at a rate of >100bpm, lasting less than 30 seconds, without haemodynamic instability
  • Sustained VT - a ventricular rhythm at a rate of >100bpm, lasting at least 30 seconds or with haemodynamic instability

Pathogenesis

  • Mechanisms

  • Monomorphic VT occurs most commonly in the context of a macro-reentrant pathway in a structurally abnormal heart. The rhythm may also be caused by a focal arrhythmogenic ventricular focus.
  • Causes of Monomorphic Ventricular Tachycardia

  • Myocardial infarction
  • Cardiomyopathy
  • Congestive cardiac failure

Diagnosis

  • ECG Findings

  • Heart rate >100bpm
  • Regular rhythm (RR interval)
  • Broad QRS complexes >120ms
  • Diagnosis
     
A left bundle branch morphology classically suggests a right ventricular focus of VT, while a right bundle morphology pattern suggests a left ventricular focus. A septal focus may manifest as either a left or right bundle branch morphology.
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