Ventricular arrhythmias are abnormal rapid heart rhythms that start in the lower chambers of the heart (the ventricles). Ventricular arrhythmias include ventricular tachycardia and ventricular fibrillation. Both are life-threatening arrhythmias most commonly associated with heart attacks or scarring of the heart muscle from a previous heart attack.
- Ventricular tachycardia (VT): A condition in which an electrical signal is sent from the ventricles (lower chambers of the heart) at a very fast but often regular rate. If the heart rate is sustained at a high rate, you may feel weakness, fatigue, dizziness and palpitations. The rapid heartbeat often causes a sudden drop in blood pressure and poor blood flow to the brain, resulting in loss of consciousness or fainting and may be life-threatening. If you experience ventricular tachycardia, oftentimes 911 is called and an electric shock to "convert" or stop the ventricular tachycardia is required.
- Ventricular fibrillation (VF): A condition in which many electrical signals are sent from the ventricles at a very fast and erratic rate. As a result, the ventricles are unable to fill with blood and pump. This rhythm is life-threatening because there is no pulse and a complete loss of consciousness. If you experience ventricular fibrillation, a prompt defibrillation (electrical shock) is necessary from 911 assistance or an automatic external defibrillator to restore the normal rhythm and beating of the heart. Ventricular fibrillation may cause sudden cardiac arrest and death.
Causes
A ventricular arrhythmia may be caused by:
- A variety of underlying cardiac conditions, including coronary artery disease and cardiomyopathy
- Abnormal levels of electrolytes (minerals) in the blood
- Toxins, such as alcohol
- Stimulants, such as cocaine and some over-the-counter medications
- Infection or inflammation of the heart muscle
Why choose Ohio State for ventricular arrhythmias treatment?
The electrophysiology team at Ohio State’s Ross Heart Hospital consists of the largest group of electrophysiologists in central Ohio as well as over 100 nursing staff members dedicated to the care of patients with heart rhythm problems. Ohio State's Ross Heart Hospital has consistently been one of the largest electrophysiology centers in the country utilizing physician experience coupled with advanced mapping and ablation technology to manage the wide spectrum of heart rhythm problems. Ohio State’s electrophysiology program is the largest program in Ohio, and one of the top three in the nation, with extensive experience in managing a wide spectrum of heart rhythm problems.
Diagnosis
The first step in the diagnosis of ventricular tachycardia or ventricular fibrillation is a medical history and physical examination by your electrical heart doctor (called an electrophysiologist). Many times, the first diagnose of a ventricular tachycardia or ventricular fibrillation is when a patient requires emergency assistance from 911. An electrocardiogram (EKG/ECG) obtained at the time of the heart rhythm problem will confirm the diagnosis of ventricular tachycardia or ventricular fibrillation. Based on your symptoms, your electrophysiologist may also recommend other tests such as:
- Holter monitor – A portable, battery-operated EKG/ECG that is worn for a day or two and provides your physician with continuous data about the electrical activity of your heart.
- Exercise stress test – A test performed on a treadmill or stationary bicycle to measure heart, lung and muscle function during physical activity. You are attached to an electrocardiogram (EKG/ECG) to record electrical activity of the heart.
- Electrophysiology (EP) study – An invasive test where the doctor inserts pacing wires through a blood vessel into the heart to evaluate the electrical system of the heart.
- Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.
Treatments
Emergency treatments for ventricular tachycardia and ventricular fibrillation include:
- Cardiopulmonary resuscitation (CPR): During ventricular tachycardia or ventricular fibrillation, the blood flow to the body and brain are inadequate. CPR can help pump blood through the body by mimicking the pumping motion of your heart.
- Automatic external defibrillators (AED): Used to deliver an electrical shock through the chest wall to the heart to stop the ventricular tachycardia or ventricular fibrillation and to restore normal rhythm and beating of the heart
Long-term therapy for managing ventricular tachycardia or ventricular fibrillation will be designed by your electrophysiologist and may include one or more of the following:
- Antiarrhythmic medications – Medications that are specifically designed to help reduce the ventricular arrhythmias
- Implantable cardioverter defibrillator (ICD) – An implanted device, inserted under the skin that monitors and treats ventricular arrhythmias by providing a prompt electrical shock
- Catheter ablation – Ablation involves inserting catheters (narrow, flexible wires) into a blood vessel and positioning the wire into the heart. The catheters are then positioned at the site of the abnormal heart rhythm and energy in the radiofrequency is delivered through the tip of the catheter to eliminate the arrhythmia.
