Ventricular tachycardia is characterized by an acceleration of the heart rate of more than 100 beats / min. with the focus of occurrence in the ventricle. In 90% of cases, it occurs in people with organic heart rhythm lesions . Most often, rhythm disturbance is associated with coronary artery disease. Myocardial infarction, congenital and rheumatic heart diseases, or various complications after therapy with psychotropic drugs or some anesthetics can also lead to tachycardia.
Symptoms
The likelihood of this disease increases with age. Men are more susceptible to it than women. In people younger than 35 years of age, myocarditis and hypertrophic cardiomyopathy can also develop ventricular tachycardia. Symptoms are as follows:
- feeling of a strong heartbeat, dizziness, anxiety;
- shortness of breath, chest pain;
- sensation of pulsation in the neck;
- in some cases, attacks of weakness and fainting are possible.
Pathophysiology
Ventricular tachycardia occurs in two manifestations: monomorphic and polymorphic tachycardia. The monomorphic variety is characterized in that the sequence of pulsed excitations is kept constant. It happens that the manifestation of this type of tachycardia occurs in people with a structurally healthy heart. In these cases, the clinical prognosis is usually favorable. Polymorphic ventricular tachycardia is characterized by variability in the sequence of ventricular activation. The cause of the disease can be myocarditis, ischemia, or genetic abnormalities in the structure of ion channels.
Tachycardia Treatment
Treatment of ventricular tachycardia is carried out by the action of antiarrhythmic drugs, which takes place against the background of measures to eliminate the underlying disease. As an antiarrhythmic agent, lidocaine is usually used. It is administered intravenously at a rate of 1 mg per kilogram of patient weight. As a rule, this dose reaches 100 mg and is administered in a few minutes. If there is no effect for 15 minutes, the drug is reused in the same
dosage. If ventricular tachycardia is accompanied by a drop in pressure, it is increased using pressor amines. This will restore the
sinus rhythm. When
cardiac glycosides are intoxicated, ventricular tachycardia is treated
with potassium chloride and lidocaine, or Obzidan is used.
Continued treatment after restoration of heart rate
When the rhythm is restored, the prognosis is evaluated and a patient management plan is drawn up. He is prescribed drug therapy or the installation of a cardioverter-defibrillator, or catheter ablation. There are combined treatment options. They are usually used if there is a serious structural pathology of the heart. Catheter ablation, for example, can increase the effectiveness of antiarrhythmic therapy or reduce the frequency of discharges of an implanted cardioverter-defibrillator.