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Nonsustained ventricular tachycardias

Last reviewed: 12 Nov 2024
Last updated: 24 Nov 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
Full details

Other diagnostic factors

  • palpitations
  • dizziness
  • lightheadedness
  • presyncope
  • syncope
Full details

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
Full details

Diagnostic tests

1st tests to order

  • ECG
  • electrolyte panel
  • troponin
  • CK-MB
Full details

Tests to consider

  • 24-hour ambulatory ECG monitoring
  • echocardiogram
  • cardiac catheterization
  • cardiac MRI with gadolinium
  • electrophysiologic testing
  • stress testing
  • genetic screening
Full details

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.

Disclosures

RRB declares that he has no competing interests.

Peer reviewers

Timothy Markman, MD

Assistant Professor of Medicine

Hospital of the University of Pennsylvania

Philadelphia

PA

Disclosures

TM 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.

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