How is Ventricular Tachycardia (V-tach) Diagnosed?

Diagnosis

To find out if you have ventricular tachycardia, your doctor will examine you and may recommend other tests. First, your doctor will ask about your symptoms and personal and family medical history. They may also perform a physical examination.

Diagnostic tests can also be done to help evaluate the heart’s function. Tests may include:

  • Electrocardiogram (ECG or EKG) measures your heart's electrical activity, rate, and rhythm
    • Holter monitor is a portable ECG device. It records the heart's electrical activity over a day or longer while you are away from the doctor's office
    • Cardiac event recorder is a portable ECG device that you control to record your heart's electrical activity when you have symptoms. It detects occasional arrhythmias and is typically worn for up to 30 days.
    • Implantable loop recorder detects irregular heart rhythms and is implanted under the skin in the chest area
  • Heart Imaging tests
    • Echocardiogram (echo) creates an image of the valves and chambers in your heart and measures the level of pumping of your heart
    • Chest X-ray shows the heart and lungs' condition and can help diagnose an enlarged heart
    • Angiography uses special X-rays that visualize blockages in the arteries in the heart, neck, brain, and other body parts. A contrast dye is injected into your arteries to highlight blockages on the X-ray images, called angiograms.
    • Coronary CT scan (computerized tomography), a test that creates an image of the inside of your body and can show your heart in detail
    • Cardiac MRI (magnetic resonance imaging) shows heart function and heart tissue inflammation or scarring
    • Cardiac PET (positron emission tomography) to look for heart tissue with alterations in metabolic activity
  • Exercise stress test measures your heart performance during physical activity. Heart problems may show during an exercise stress test because your heart pumps harder than when you are resting.
  • Electrophysiological (EP) test and cardiac mapping is a test to confirm that you have V-tach and to find the location of the abnormal heartbeat

How is Ventricular Tachycardia Treated?

Treatment

Ventricular tachycardia treatment aims to control a fast heartbeat during an episode and prevent future episodes from happening. Treatments include medications or procedures to control the heart rhythm.

Medication

Several antiarrhythmic medications are used to prevent V-tach. Other heart medications, such as calcium channel blockers and beta blockers, may be prescribed with antiarrhythmic drugs.

Procedures to treat heartbeat problems

  • Defibrillation is a medical procedure used to control an abnormally fast heart rate, such as in sustained V-tach or other cardiac arrhythmias, and restore a normal rhythm using electricity or medications.

    In defibrillation, electrodes placed on the chest send electric shocks to the heart. The shock changes the heart's electrical signals and restores the regular heartbeat. A shock can also be delivered to the heart using an automated external defibrillator (AED). Pharmacologic cardioversion, also called chemical cardioversion, uses antiarrhythmic medication instead of an electrical shock.
  • Catheter ablation may be needed to help prevent or manage episodes of ventricular tachycardia and other problems with a heartbeat. In this procedure, the extra electrical pathway or cells in the heart that are causing the fast heart rate can be identified and destroyed. Your doctor will insert thin, flexible tubes called catheters through the veins or arteries. Sensors on the catheter can measure areas of the heart with irregular electrical signals. An ablation catheter then delivers treatment to the area.
  • Implanted Devices
    • Implantable cardioverter-defibrillator (ICD) is a device implanted either in the heart or under the skin in the chest area. This device monitors the heartbeat and delivers electrical shocks to restore a regular heart rhythm when a life-threatening arrhythmia is detected.

Surgical treatments

Surgical procedures such as a VT ablation may be needed to deliver treatment to an extra electrical pathway that causes tachycardia. Ablation is performed after shared decision-making between the electrophysiologist and the patient.

FAQs

FAQs

When the heart beats faster than average, it is called tachycardia. Ventricular tachycardia is a type of tachycardia. If you have an episode of tachycardia, you may feel a racing, pounding heartbeat or palpitations, a feeling of flopping in the chest. You may feel dizziness, lightheadedness, shortness of breath, loss of consciousness, or fainting.

 

Your doctor will decide the best treatment for you after examining you and considering your health history. Treatment options may include medications and procedures to treat your arrhythmia.

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Trust NewYork-Presbyterian for Ventricular Tachycardia Treatment

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