Do you sometimes feel like your heart is beating very fast, pounding? You may even hear your chest pounding, feel a little short of breath, or feel dizzy. If you have had this experience, or if you have heard of someone you know experiencing this, it is important for you to be aware of the condition we are going to talk about today, called Ventricular Tachycardia.
What exactly is this rapid heartbeat (Ventricular Tachycardia)?
Simply put, `(Ventricular Tachycardia)` is when your heart beats at a rate of more than 120 beats per minute. But the special thing about this is that this rapid heartbeat does not start from the normal electrical signal system of the heart. Normally, our heart should start beating from an electrical signal coming from a place called the `(Sinoatrial Node)`, which acts like a switch at the top of the heart. But in `(Ventricular Tachycardia)`, this heartbeat starts from the two main chambers at the bottom of the heart, that is, the ventricles . This is the problem that occurs because something goes beyond the normal electrical pathway of the heart.
When we're normally at rest, our hearts beat between 60 and 100 times per minute, right? So imagine what happens when this number suddenly increases to over 120! When the heart beats this fast, these main things happen:
- Your blood pressure may drop suddenly.
- The heart doesn't have enough time to properly fill the chambers with blood and pump it back out to the body. As a result , other parts of the body, especially the brain and limbs, don't get the oxygen they need.
- For these reasons, you start to experience various symptoms.
Is this really a serious situation?
Yes, this is a very serious condition, and it requires immediate treatment. If this rapid heartbeat called `(Ventricular Tachycardia)` lasts for more than 30 seconds (we call this `sustained Ventricular Tachycardia`), it can progress to an even more serious condition called `(Ventricular Fibrillation)`. If that happens, there is a possibility of sudden cardiac arrest and even death. So this is not something to be taken lightly.
What is the difference between `(Ventricular Tachycardia)` and `(Ventricular Fibrillation)`?
Both are abnormally fast heart rhythms. However, ``Ventricular Fibrillation'' is a more serious and life-threatening condition than ``Ventricular Tachycardia''.
Imagine, in `(Ventricular Tachycardia)` the heart beats fast, but it pumps some blood to the body. But because of that speed, the body does not get enough blood.
But in `(Ventricular Fibrillation)`, instead of beating properly, the heart muscle just twitches. Then the heart does not pump blood to the body at all. This can cause `sudden cardiac death` .
Can Ventricular Tachycardia get better on its own ?
Yes, in some cases this may only last a few seconds and the heart rhythm may return to normal. In such cases, there will be no major damage. But we cannot expect that to happen all the time.
Who is more likely to develop this? - Risk factors
There are some risk factors that can affect the development of `(Ventricular Tachycardia)`. If you have these things, you are more likely to develop this condition than others:
- If you have previously developed heart disease .
- If anyone in your family has had heart rhythm issues (that is, a hereditary link).
- If you have coronary artery disease .
- If you have a condition called ``Myocarditis'' , which is inflammation of the heart muscle.
- If you have heart failure .
- If the heart is enlarged, it means you have cardiomyopathy .
- If you have heart valve disease .
- If you have previously had a heart attack (`Myocardial Infarction`) or if you have had heart surgery.
- If there is a serious imbalance in the body's electrolytes , that is, salts (such as potassium and magnesium).
- If you use certain stimulant drugs (for example, cocaine, methamphetamine).
How does Ventricular Tachycardia affect my body?
When `(Ventricular Tachycardia)` occurs, your heart beats so fast that the chambers of the heart don't get enough time to fill with blood before the next beat. Imagine a bus stopping at a stop for a very short time. Then not everyone gets time to get on the bus, and some get left on the road. That's what happens here too. When the heart doesn't have enough time to fill with blood, the amount of blood pumped throughout the body decreases. Then the cells and tissues of the body get less oxygen and nutrients.
What are the symptoms of this?
The symptoms of `(Ventricular Tachycardia)` can vary from person to person. Some people may not have any symptoms. But these are the most common symptoms. If you experience any of these symptoms, you should go to the emergency room immediately. This can lead to cardiac arrest and even death.
- Chest pain or tightness.
- Difficulty breathing.
- Feeling the heart beating fast, hearing the chest pounding (`Palpitations/rapid pulse`).
- Dizziness, lightheadedness, or passing out.
The most important thing is not to ignore these symptoms. Even though they may seem like a minor thing, they can be life-threatening.
Why does this `(Ventricular Tachycardia)` occur?
Okay, now let's see why this happens. When abnormal electrical signals occur in the lower chambers of your heart, called the ventricles, those signals clash with the signals coming from the sinoatrial node, which controls the normal rhythm of the heart. This causes the heart to beat out of control and very fast. This speed does not allow the chambers of the heart to fill with blood.
Most people with Ventricular Tachycardia have another underlying heart condition. The main causes are:
- Coronary Artery Disease.
- Heart failure.
- Myocarditis .
- Enlargement of the heart (Cardiomyopathy) .
- Heart valve disease .
- Previous heart surgery .
- Scar tissue in the heart due to a previous heart attack (`Myocardial Infarction`) .
- Other medical conditions such as `(Sarcoidosis)` .
- Some inherited conditions .
There are other causes that are not related to the heart, but can cause `(Ventricular Tachycardia)`:
- Some medications .
- Imbalance of electrolytes in the body (these are the minerals that control the heart's rhythm).
- Excessive caffeine or alcohol intake.
- Use of illegal drugs (`Recreational drugs`) .
- Sometimes it can also be due to excessive exercise .
Sometimes it may not be possible to find a reason for this.
What is the most common reason?
The most common cause of `(Ventricular Tachycardia)` is ischemic heart disease . This is what we call coronary heart disease or coronary artery disease. Simply put, the heart muscle does not get enough blood and oxygen due to blockages in the coronary arteries. These blockages are often caused by atherosclerosis .
How to recognize `(Ventricular Tachycardia)`?
To find out for sure if you have `(Ventricular Tachycardia)`, your doctor will do these things:
- They will talk to you in detail about your symptoms.
- A physical exam will be performed, including checking your pulse rate.
- Collects information about your medical history .
- It orders several necessary tests to be performed.
What tests are done for this?
The main and most commonly used test to diagnose Ventricular Tachycardia is an electrocardiogram (ECG/EKG) . This records the electrical activity of your heart.
In addition, other tests can be done, such as:
- Holter monitor: This is a small device that continuously records your heart rhythm for 24 or 48 hours.
- Electrophysiology study (EPS): This involves passing a thin wire into the heart and examining the heart's electrical system in depth.
- Cardiac event monitor: This is similar to a Holter monitor, but you can activate it yourself and record your heartbeat when you have symptoms.
- Treadmill stress test: This tests how your heart responds when you exercise (run on a treadmill).
- Echocardiogram: This is an ultrasound scan of the heart. It can look at the structure and function of the heart.
- Blood tests: Check things like electrolyte levels and heart enzymes.
How is Ventricular Tachycardia treated?
If you have symptoms, or if you have Ventricular Tachycardia for more than 30 seconds even if you don't have symptoms, you definitely need treatment.
When treating this, the main thing is to treat the underlying disease that caused the condition. These treatments can improve this abnormal heartbeat and prevent it from coming back.
The emergency treatment for Ventricular Tachycardia is:
- CPR (Cardiopulmonary Resuscitation): A first aid procedure to save a life if the heart stops beating.
- Electrical defibrillation: An electric shock is given to the heart to try to restore it to a normal rhythm.
- IV medications: Control heart rate.
In non-emergency cases, the usual treatments are:
- Radiofrequency Catheter Ablation (RCA): In this, the exact location of the abnormal heart rhythm is found, and a catheter (a thin tube) is used to destroy the tissue at that location with an electric current.
- Implantable Cardioverter-Defibrillator (ICD): This is a small device that is surgically implanted under the skin near the heart. It continuously monitors your heart rhythm. If a ventricular tachycardia occurs, the device detects it and immediately sends an electrical signal to restore the heart to a normal rhythm.
- Medications: Medications are given to slow down the heart rate and maintain a normal rhythm. However, some medications can have side effects. Your doctor will explain these to you.
Are there any complications in the treatment?
Catheter ablation for ventricular tachycardia is generally safe and effective. However, some complications can occur very rarely. These include:
- Damage to your heart or blood vessels.
- Blood clots.
- Bleeding.
- Infection .
How long does it take to recover after treatment?
After a `(Ventricular Tachycardia Ablation)`, you will need to stay in the hospital for at least one night. You can usually return to normal activities within a few days after leaving the hospital. However , it is not recommended to do anything heavy or strenuous for at least three days, or until your doctor tells you to.
How can I reduce this risk?
By avoiding heart diseases that cause Ventricular Tachycardia, you can reduce the risk of developing this condition.
You can do these things to protect yourself from coronary artery disease, the most common cause of this:
- Eat a healthy low-fat, low-salt diet .
- Exercise often.
- Maintain a healthy weight.
- Completely stop using all tobacco products.
- Take the medication your doctor prescribes for high blood pressure and high cholesterol exactly as prescribed.
What happens if I have `(Ventricular Tachycardia)`? (Prognosis)
Your prognosis depends on how severe your Ventricular Tachycardia is and whether you have other heart conditions. The condition can be serious, especially if the left ventricle of your heart is not working properly. But with proper treatment, most people can live a normal life.
Can Ventricular Tachycardia be completely cured?
This depends on the underlying cause. For some people, Radiofrequency Catheter Ablation can completely cure this abnormal rhythm, and no further treatment is needed. Devices called Implantable Cardioverter Defibrillators (ICDs) do not cure this, but they are very effective in helping to restore the heart to a normal rhythm by delivering a rapid beat or shock in life-threatening cases of Ventricular Tachycardia.
How do I take care of myself?
As a person with `(Ventricular Tachycardia)`, you should do these things to take care of yourself:
- Follow a heart-healthy diet and exercise plan recommended by your medical team.
- Stop using tobacco products.
- Continue to take the medications your doctor has prescribed for you as prescribed, without skipping any doses.
When should I see my doctor?
It is very important to see your doctor regularly for follow-up tests. Your doctor will want to:
- See how you are.
- Make sure your treatment is working properly.
- Talk about any new symptoms you have or changes in the way you feel.
When should I go to an Emergency Treatment Unit (ETU) ?
If you experience any of these symptoms, call 1990 (if in Sri Lanka) immediately, or go to an emergency room immediately:
- Chest pain.
- Fainting.
- A fast and abnormal pulse.
Don't drive alone at a time like this. Ask for help as soon as possible.
What questions should I ask my doctor?
When you go to see the doctor, don't hesitate to ask questions like these. It's very important that you have a good understanding of your condition.
- How often do I need to come for ``follow-up`` tests?
- Will I need an ICD?
- Will I have to have a catheter ablation again?
- What changes do I need to make in my lifestyle?
Being aware of your heart rate and how you feel can help you get treatment when you need it. Early treatment for Ventricular Tachycardia is very important. So if you or a loved one needs help, don't put it off. Even after leaving the hospital, follow the doctor's instructions exactly. Take the medication exactly as prescribed. Adopt a healthy lifestyle. Especially if you have a medical device installed as a treatment, attend `(follow-up)` tests without missing a beat.
Finally, things to remember
Ventricular Tachycardia is a fast, abnormal heartbeat that starts in the lower chambers of the heart. This can be a serious condition, so don't ignore the symptoms. If you experience chest pain, difficulty breathing, dizziness, or fainting , seek medical attention immediately.
Fortunately, there are effective treatments for this condition. Medications, catheter ablation, and ICD devices can help control the condition. The most important thing is to follow your doctor's instructions and live a healthy lifestyle. Then you can live well with this condition.
` Heart rate, heart disease, tachycardia, sudden cardiac arrest, heart rhythm, heart treatment, ICD
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