Treatment Options for Ventricular Tachycardia

Ventricular tachycardia (VT) is generally categorized into two types: sustained VT and nonsustained VT. Nonsustained VT typically lasts less than 30 seconds and does not cause hemodynamic changes. In contrast, sustained VT lasts longer than 30 seconds or causes symptoms such as low blood pressure and hemodynamic instability, even if the duration is shorter.

Managing Nonsustained Ventricular Tachycardia

In cases of nonsustained VT, oral antiarrhythmic medications are often sufficient to manage the condition. One commonly prescribed medication is mexiletine, which helps regulate heart rhythm. These medications are usually well tolerated and can be taken on a long-term basis to prevent recurrence.

Treating Sustained Ventricular Tachycardia

For sustained VT, more aggressive treatment is required. Intravenous medications such as amiodarone are typically administered in a hospital setting. These drugs are more potent than their oral counterparts and are designed to rapidly stabilize the heart's electrical activity.

When Medication Isn't Enough

If pharmacological treatment fails to restore normal heart rhythm, electrical cardioversion may be necessary. This procedure involves delivering a controlled electric shock to the heart to reset its rhythm. In some cases, implantable cardioverter-defibrillators (ICDs) may be recommended for long-term management.

Advanced Therapies: Radiofrequency Ablation

For patients who experience recurrent episodes of VT, radiofrequency ablation may be considered. This minimally invasive procedure targets and destroys the specific areas of heart tissue responsible for the abnormal electrical signals. It offers a potentially curative option and can significantly improve quality of life for many patients.