Actualización en taquicardia ventricular

Abstract

Ventricular tachycardia usually occurs in patients with structural heart disease and is associated with sudden death. Acute ischemia can cause polymorphic ventricular tachycardia and ventricular fibrillation. Scar tissue may provide the anatomic substrate for reentrant ventricular arrhythmias, manifested most commonly by monomorphic ventricular tachycardia. Less frequently, ventricular tachycardias occur in patients without structural heart disease. These patients generally have a good prognosis and therapy is usually curative. Implantable cardioverter defibrillator therapy is recommended in most patients with ventricular tachycardia with structural heart disease. The acute management of polymorphic ventricular tachycardia is directed to find and to treat precipitating causes such as ischemia or bradycardia. Monomorphic ventricular tachycardia should be treated with antiarrhythmic drugs. Radiofrequency ablation plays a remarkable role in the treatment of idiopathic ventricular tachycardia, arrhythmic storm and in the prevention of defibrillator shocks. Its use is growing exponentially in last years. Clinical and electrocardiographic characteristics, diagnosis and treatment of the vetricular tachycardia are described in this chapter. Finally, idiopathic ventricular tachycardias will be briefly reviewed as well.