Tachyarrhythmia: Ventricular Tachycardia (V-tach)

by Carlo Raj, MD

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    Alright so at this point, you think we were being redundant. Take a look at the category for arrhythmias, still dysarryhthmia and conduction system diseases but up until now we have only done SVTs. What is left? All important ventricles. Now here once again the way that I am setting up this for you is I'm going have you prepared for everything when you walk into your wards, but along the way though, we are going to then point out those incredibly important ventricular arrhythmias that you have to be aware of for any licensing exam. So let us begin and by the time we are down with the session, you will be extremely comfortable with just about any type of arrhythmia taking place due to a conduction system disease. Anything that will be left thereafter will be arrhythmias that are then secondary to vascular diseases. Causes of ventricular tachycardia. Before we begin, since we were doing the ventricles, then you tell me as to what particular complex we are paying attention to. QRS complex only. The P wave has been left alone because P wave is dealing all of our SVTs and those included atrial flutter, atrial fibrillation, mutifocal atrial tachycardia and WPW. Here under ventricular, we will speed things up in which a QRS complex are closer to one another. The R wave are closer to one another and hence, you have an increase in heart rate. Remember greater than 100 beats per minute. Causes include ischemia, right ventricular outflow tract obstruction, structural heart diseases or medication induced. So, nothing really specific and you really making sure or you are trying to prevent from ventricular arrhythmias to take place to begin with because you are always worried about going into v.fib and hence death. What is the definition...

    About the Lecture

    The lecture Tachyarrhythmia: Ventricular Tachycardia (V-tach) by Carlo Raj, MD is from the course Arrythmias. It contains the following chapters:

    • Diagnosis
    • Typical Pattern
    • Treatment
    • Torsade de Pointes

    Included Quiz Questions

    1. QRS complex is usually < 120 milliseconds.
    2. Heart rate > 100 bpm.
    3. Evidence of AV dissociation.
    4. Must have 3 or more irregular beats in a row.
    5. Must originate distal to the bundle of His.
    1. Bizzare, widened QRS complex which is not preceded by a p wave with the subsequent T wave oriented in the opposite direction.
    2. Slurred upstroke before the QRS complex associated with a shortened PR interval.
    3. Delayed repolarization of the heart following a heartbeat.
    4. Multiple ventricular foci with the resultant QRS complexes varying in amplitude, axis and duration.
    5. Any cause of a skipped beat, pause or palpitation.
    1. Left bundle branch block.
    2. Right bundle branch block.
    3. Atrial fibrillation.
    4. Wolff-Parkinson White.
    5. Atrial septal defect.
    1. Right bundle branch block
    2. Left bundle branch block
    3. Long QT syndrome
    4. Torsades de pointes
    5. Atrial septal defect
    1. Lead 1, aVL, V5, V6
    2. II, III, aVF
    3. V5-V6
    4. Lead II
    5. V1-V4
    1. …ventricular fibrillation.
    2. …hypotension.
    3. …pulseless activity.
    4. …cardiac remodeling.
    5. …transmission to the atria.
    1. Decreased diastolic filling.
    2. Increased afterload.
    3. Delayed ventricular repolarization.
    4. Decreased preload.
    5. Disorganized contractions .
    1. Sedation
    2. Dobutamine
    3. Procainamide
    4. Beta blockers
    5. Electrical cardioversion
    1. Slurred upstroke of QRS complex.
    2. Patient has history of ischemic cardiomyopathy.
    3. P waves independent of QRS on ECG.
    4. AV dissociation on ECG.
    5. Widened QRS complex.
    1. Phase 3 – potassium efflux
    2. Phase 1 – potassium efflux
    3. Phase 4 – potassium influx
    4. Phase 2 – calcium influx
    5. Phase 0 – sodium influx
    1. Hypermagnesemia
    2. Fluoroquinolones
    3. Tricyclic antidepressants
    4. Lange Neilsen syndrome
    5. Bradycardia
    1. They prolong ventricular repolarization.
    2. They increase potassium efflux.
    3. They slow conduction through the AV node.
    4. They increase the heart rate.
    5. They block voltage gated sodium channels.

    Author of lecture Tachyarrhythmia: Ventricular Tachycardia (V-tach)

     Carlo Raj, MD

    Carlo Raj, MD

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