Non-sustained ventricular tachycardias

An ectopic ventricular rhythm on ECG consisting of 3 or more consecutive, wide (duration ≥120 milliseconds) QRS complexes with a rate greater than 120 bpm, spontaneously resolving in less than 30 seconds.

Usually asymptomatic, although brief palpitations may sometimes be experienced. Symptoms in a patient with known non-sustained ventricular tachycardia (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 (ICD) 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 resynchronisation therapy (CRT).

Prognosis dependent on presence or absence of cardiac disease. Left ventricular function in post-MI 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.

Non-sustained ventricular tachycardia (NSVT) is an ectopic ventricular rhythm with wide QRS complex (120 milliseconds or greater), rate faster than 120 bpm, lasting for at least 3 beats that spontaneously resolves in less than 30 seconds.[1]Buxton AE, Duc J, Berger EE, et al. Nonsustained ventricular tachycardia. Cardiol Clin. 2000 May;18(2):327-36,viii. http://www.ncbi.nlm.nih.gov/pubmed/10849876?tool=bestpractice.com It may occur in the absence of any underlying heart disease. However, it is more commonly associated with ischaemic and non-ischaemic heart disease; known genetic disorders such as long QT syndrome, Brugada's syndrome, and arrhythmogenic right ventricular cardiomyopathy; congenital heart disease; metabolic problems, including drug toxicity; or electrolyte imbalance.[2]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