Nonsustained ventricular tachycardias

Nonsustained ventricular tachycardia (NSVT) is usually asymptomatic, although brief palpitations may sometimes be experienced. Symptoms in a patient with known NSVT are most often attributed to underlying cardiac disease rather than the arrhythmia itself.

Defined as a self-terminating event. No specific treatment indicated. Management is directed at any underlying heart condition.

Implantable cardioverter defibrillator placement may be used for selected patients who have additional risk factors such as structural heart disease. Patients at risk for sudden cardiac death and who also have discordant contraction of left ventricular function may benefit from cardiac resynchronization therapy.

Prognosis dependent on presence or absence of cardiac disease. Left ventricular function in post-myocardial infarction patients remains the most important prognostic tool for overall mortality and risk for sudden cardiac death.

No increase in mortality demonstrated in those patients without associated cardiac disease.

Nonsustained ventricular tachycardia (NSVT) is an ectopic ventricular rhythm with wide QRS complex (≥120 milliseconds), rate faster than 100 bpm, lasting for at least 3 beats that spontaneously resolves in less than 30 seconds.[1]Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Circulation. 2018 Sep 25;138(13):e272-e391. https://www.doi.org/10.1161/CIR.0000000000000549 http://www.ncbi.nlm.nih.gov/pubmed/29084731?tool=bestpractice.com [2]Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022 Oct 21;43(40):3997-4126. https://academic.oup.com/eurheartj/article/43/40/3997/6675633?login=false http://www.ncbi.nlm.nih.gov/pubmed/36017572?tool=bestpractice.com ​​​ It may occur in the absence of any underlying heart disease. However, it is more commonly associated with ischemic and nonischemic heart disease; known genetic disorders (e.g., long QT syndrome, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy); congenital heart disease; metabolic problems including drug toxicity; or electrolyte imbalance.[3]Nathani P, Shetty S, Lokhandwala Y. Ventricular tachycardia in structurally normal hearts: recognition and management. J Assoc Physicians India. 2007 Apr;55(suppl):33-8. http://www.ncbi.nlm.nih.gov/pubmed/18368865?tool=bestpractice.com