Nonsustained ventricular tachycardias

Last reviewed: 2 Sep 2023
Last updated: 26 Apr 2023

Summary

Definition

History and exam

Key diagnostic factors

  • history of coronary artery disease
  • history of hypertrophic cardiomyopathy
  • history of idiopathic dilated cardiomyopathy
  • presence of other known causes
  • asymptomatic presentation
  • tachycardia
More key diagnostic factors

Other diagnostic factors

  • palpitations
  • dizziness
  • lightheadedness
  • presyncope
  • syncope
Other diagnostic factors

Risk factors

  • coronary artery disease
  • left ventricular systolic dysfunction
  • hypertrophic cardiomyopathy
  • idiopathic dilated cardiomyopathy
  • long QT syndrome
  • Brugada syndrome
  • electrolyte imbalance
  • drug toxicity
  • Chagas disease and other cardiomyopathies
  • sleep-disordered breathing
  • catecholaminergic polymorphic VT
  • family history of sudden death
  • mental or physical stress
More risk factors

Diagnostic investigations

1st investigations to order

  • ECG
  • electrolyte panel
  • troponin
  • CK-MB
More 1st investigations to order

Investigations to consider

  • 24-hour ambulatory ECG monitoring
  • echocardiogram
  • cardiac catheterization
  • cardiac MRI with gadolinium
  • electrophysiologic testing
  • stress testing
  • genetic screening
More investigations to consider

Treatment algorithm

ONGOING

no cardiac comorbidity: asymptomatic and ≤10% NSVT/premature ventricular contraction (PVC) burden

no cardiac comorbidity: symptomatic NSVT or >10% asymptomatic NSVT/premature ventricular contraction (PVC) burden

chronic coronary artery disease (CAD)

post-myocardial infarction (MI)

idiopathic dilated or hypertrophic cardiomyopathy

Contributors

Authors

Fred Kusumoto, MD
Fred Kusumoto

Professor of Medicine

Mayo Medical School

Division of Cardiovascular Diseases

Department of Medicine

Mayo Clinic Florida

Jacksonville

FL

Disclosures

FK declares that he has no competing interests.

Acknowledgements

Professor Kusumoto would like to gratefully acknowledge Dr Ronald R. Butendieck Jr, a previous contributor to this topic. RRB declares that he has no competing interests.

Peer reviewers

Sarabjeet Singh, MD

Cardiology Fellow

Adult Cardiovascular Fellowship

Department of Cardiology

Chicago Medical School (CMS) and affiliated hospitals

Chicago

IL

Disclosures

SS declares that he has no competing interests.

Vias Markides, MB(Hons), BS(Hons), MD, FRCP

Consultant Cardiologist and Chair

Arrhythmias

Royal Brompton & Harefield NHS Trust

Hon. Senior Lecturer

Imperial College

London

UK

Disclosures

VM declares that he has no competing interests.

  • Nonsustained ventricular tachycardias images
  • Differentials

    • SVT with aberrant conduction
    • Electrical artifact
    More Differentials
  • Guidelines

    • 2022 ESC guideline for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death
    • 2022 AHA/ACC/HFSA guideline for the management of heart failure
    More Guidelines
  • Patient leaflets

    Heart attack

    Heart attack: what is it?

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer