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Ventricular tachycardia
Expert reviewer, Dr Tim Cripps, Consultant Cardiologist
Next review due December 2022
Ventricular tachycardia is a type of abnormal heartbeat (arrhythmia) in which your heart beats too fast. Most people who get ventricular tachycardia have already had some problems with their heart, such as a previous heart attack or heart muscle disease (cardiomyopathy).
What happens in ventricular tachycardia?
Your heartbeat is controlled by electrical signals (impulses) that travel through your heart and make it contract. In ventricular tachycardia, faulty electrical signals in your ventricles (the lower chambers of your heart) cause your heart to beat faster than normal.
Normally, at rest, your heart will beat between 60 and 100 times a minute. If you have ventricular tachycardia, it beats over 100 times per minute – often more than 120 times per minute. However, although your heart might be beating faster, it’s not pumping blood so efficiently. Because your ventricles are beating too quickly, they might not have enough time to fill up with blood between beats. Your heart then can’t pump enough blood to the rest of your body.
Attacks of ventricular tachycardia can sometimes stop on their own after a few seconds (non-sustained). But if it carries on for longer than 30 seconds (sustained ventricular tachycardia), it will usually cause symptoms and you may need treatment to stop it.
Watch our animation to see how your heart beats normally and what happens in ventricular tachycardia.
Symptoms of ventricular tachycardia
Symptoms of ventricular tachycardia can include:
- palpitations (a thumping or fluttering feeling in your chest)
- chest pain or discomfort
- difficulty breathing
- feeling sick
- sweating a lot
- feeling light-headed or passing out
If you just have brief episodes of ventricular tachycardia that stop on their own, you may not get any symptoms at all.
If you do get any of these symptoms and they’re relatively mild, see your GP. If the symptoms are severe and come on suddenly, you should go to your nearest accident and emergency department.
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Need a GP appointment? Telephone or Video GP serviceComplications of ventricular tachycardia
It’s important to get prompt treatment for ventricular tachycardia. If it lasts for a long time or is very fast and not treated quickly, it can be fatal, causing ‘sudden cardiac death’.
Ventricular tachycardia can sometimes lead to another type of arrhythmia called ventricular fibrillation. This is when electrical signals fire off in different areas of your ventricles at the same time and cause an extremely fast, life-threatening heart rhythm. It results in your heart being unable to beat properly which means little or no blood is pumped out. Ventricular fibrillation is more likely to lead to sudden cardiac death, but it can be reversed if you get treatment straight away.
Watch our animation to see what happens in ventricular fibrillation.
Diagnosis of ventricular tachycardia
If you see your GP with symptoms of an arrhythmia, they’ll want to ask about your symptoms and examine you. They’ll also ask about your medical history. Your doctor will check your pulse and blood pressure, and listen to your heartbeat.
You’ll need to have a test called an electrocardiogram (ECG). An ECG records the electrical activity of your heart to see how well it's working.
You may need to have an ambulatory ECG. This records your heartbeat over a period of 24 hours or more while you go about your normal daily activities. If it’s not been possible to record the abnormal heartbeat using external monitors, you might need to have an implantable loop recorder. This is a small device which is implanted under your skin and is programmed to record abnormal rhythms. Your GP will need to refer you to a cardiologist (a doctor specialising in diagnosing and treating heart conditions) to have this.
If your ECG test shows you have ventricular tachycardia, your doctor will ask you to have some more tests, which may include the following.
- Blood tests. These will check for certain substances in your blood that can be associated with ventricular tachycardia or other conditions that may be causing your symptoms.
- Echocardiogram. This is a type of scan that uses ultrasound (sound waves) to produce a clear image of your heart muscles and valves to see how well it’s working.
- Chest X-ray. This allows your doctor to look for any changes in your heart or lungs that might be causing the problem.
- An exercise ECG (cardiac stress test). This is when you have an ECG while you exercise on a treadmill to see if it triggers an arrhythmia.
- Coronary angiography. This is a type of X-ray that uses a dye to show your coronary arteries. It can show if they’re narrowed or blocked.
- An MRI scan of your heart. This is to check if you have any problem with your heart muscle.
Treatment of ventricular tachycardia
Treatment for ventricular tachycardia aims to stop the attack and get your heart back to a normal rhythm, and then prevent you getting further attacks. Sometimes episodes of ventricular tachycardia stop on their own.
The type of treatment you have will depend on how serious your ventricular tachycardia is, and what’s causing it. If it’s caused by an underlying health condition, your doctor will also treat that.
Stopping an attack
If your heart stops due to ventricular tachycardia (a cardiac arrest), you’ll need immediate defibrillation (electric shock treatment), along with cardiopulmonary resuscitation (CPR) to re-start your heart.
If defibrillation isn’t needed, but your ventricular tachycardia has been going on for some time, you may have one or more of the following to stop it.
- Electrical cardioversion. This uses an electric shock to restore your rapid heartbeat back to normal. It’s similar to defibrillation, but the electrical burst can be timed.
- Antiarrhythmic medicine, such as amiodarone through a drip in your arm.
- Overdrive pacing. This is where a thin tube is placed on your skin or gently guided through a vein to your heart. It gives electrical impulses to control your heartbeat.
Long-term treatment
If your doctor thinks you may be at ongoing risk of ventricular tachycardia attacks, they’ll offer you treatment aimed at preventing or stopping any further attacks. What treatment you are offered will depend on your own individual circumstances. Your doctor will discuss your options with you. They may include one or more of the following.
Implantable cardioverter defibrillator (ICD)
Most people who have previously had a ventricular tachycardia attack for which there isn’t a treatable cause, have an implantable cardioverter defibrillator (ICD) fitted. An ICD is a device that’s put under your skin or muscle, usually near your collarbone, and has leads into your heart. It can detect an attack of ventricular tachycardia starting and then deliver electrical pulses or shocks to restore your heartbeat to normal. For more information, see our FAQ: What happens when my ICD delivers a shock?
You’ll usually have check-ups about every three months to check how well your ICD is working. Some types of ICD allow your clinic to monitor its effect remotely using software installed in your home.
Medicines
You might be prescribed medicines instead of or in addition to an ICD to help control your heart rate and rhythm. Medicines you may have include:
- beta-blockers
- calcium-channel blockers
- other antiarrhythmic medicines such as amiodarone
Always read the patient information leaflet that comes with your medicine and ask your doctor if you have any questions.
Radiofrequency ablation
Depending on what’s causing your ventricular tachycardia, you may be given the option of having radiofrequency ablation to stop future attacks. These procedures use radiofrequency energy to destroy the tissue in your heart that's disrupting or causing abnormal electrical signals.
You might have catheter ablation, in which a thin tube (an electrode catheter) is passed up to your heart via a vein in your groin. Or you might have epicardial ablation, in which the catheter is passed through the skin of your chest and into the outer layer of your heart wall.
Lifestyle changes
In addition to the treatments outlined above, your doctor may advise you to make some lifestyle changes to reduce your risk of further attacks. These may include making some changes to your diet, or avoiding caffeine if this seems to set off your symptoms. In certain situations, you may be advised to avoid strenuous physical activity, at least until your symptoms are under control.
If you smoke, it’s always advisable to give up – and this is particularly so if you have ventricular tachycardia. Giving up smoking can reduce your risk of sudden cardiac death from ventricular tachycardia.
Causes of ventricular tachycardia
Ventricular tachycardia usually happens in people who have already had significant problems with their heart. These are most often:
- a previous heart attack
- coronary heart disease
- heart muscle disease (cardiomyopathy)
Other problems affecting the structure of your heart may also lead to ventricular tachycardia. These include problems that you’re born with (congenital heart disease) such as the conditions called long QT syndrome and Brugada syndrome.
It’s also possible to get ventricular tachycardia if you don’t have any underlying problems with your heart. Certain things can trigger ventricular tachycardia, if you’re already at risk. These may include:
- some types of medicine
- physical or mental stress
- having too much caffeine
- illegal drugs such as cocaine
- imbalances of certain chemicals in your blood (for example, too low a level of potassium, calcium or magnesium)
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Can I drive if I have ventricular tachycardia?
This will depend on how well your ventricular tachycardia is controlled and the type of vehicle you want to drive. You shouldn’t drive if you have symptoms that have affected or are likely to affect your ability to drive. These include dizziness and breathlessness. If this is the case, you should let the Driver and Vehicle Licensing Agency (DVLA) know. If your ventricular tachycardia has been controlled for at least four weeks, you should be able to start driving again.
There are also some rules around when you can drive after certain procedures you may have for ventricular tachycardia. For example, if you have catheter ablation, you mustn't drive a car or motorbike for at least two days after your procedure.
If you have an implantable cardioverter defibrillator (ICD) fitted, you won’t be allowed to drive for six months afterwards, and you’ll need to inform the DVLA. If you have a shock from your ICD, you’ll need to let the DVLA known, and you won’t be able to drive for another six months. This may be longer if the shock affected your ability to drive.
The rules about driving are different if you have an arrhythmia and drive a lorry or are responsible for passengers. Always follow your doctor’s advice and check the DVLA website before you drive.
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What happens when my ICD delivers a shock?
A shock from an ICD can be painful if you’re conscious when the device delivers it. It can feel like a sharp thump or kick. It’s a good idea to know what to expect so you can prepare yourself and plan what to do in advance. You may want to talk to your family and friends about this, so they know what they can do to help support and reassure you. If someone is touching you when your ICD delivers a shock, they’ll notice the jolt and might feel a tingling sensation. But don’t worry – it won’t harm them.
You may have some warning signs before the ICD shocks you; for example, you may feel dizzy or have palpitations (a thumping in your chest). If so, sit or lie down so that you don’t hurt yourself in case you collapse. It's possible you’ll pass out or collapse due to your ventricular tachycardia before your ICD shocks you. In this case, you won’t be aware of the shock. Ask your family and friends to stay calm and to stay with you. Usually, you should recover quite quickly after a shock from an ICD, but you may want to rest for a while.
If you get a single shock and no associated symptoms, you’ll usually need to follow up with your ICD centre within a week. Follow the advice given to you by your clinic though, as it may differ from what we say here. If you have multiple shocks, you have symptoms or you still feel unwell after an ICD shock, go to an accident and emergency department. A doctor will check your device to find out why it shocked you.
If you or your family and friends have any concerns about your ICD, speak to your doctor. There may also be support groups in your area that you can contact. Find out what’s available to you.
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Related information
Beta-blockers
Beta-blockers are medicines which make your heart beat more slowly and with less force.
Echocardiogram
An echocardiogram is a test that uses ultrasound (sound waves) to produce moving, real-time images of your heart.
Electrocardiogram (ECG)
An electrocardiogram (ECG) is a test that can record the rhythm and electrical activity of your heart to find out if it’s healthy.
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Other helpful websites
- Arrhythmia Alliance
01789 867 501
www.arrhythmiaalliance.org.uk - The British Heart Foundation
0300 330 3311
www.bhf.org.uk
- Arrhythmia Alliance
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Sources
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- Implantable cardioverter defibrillators and cardiac resynchronisation therapy for arrhythmias and heart failure. National Institute for Health and Care Excellence (NICE), June 2014. www.nice.org.uk
- Implantable cardioverter defibrillators (ICDs). British Heart Foundation, published February 2018. www.bhf.org.uk
- Percutaneous (non-thoracoscopic) epicardial catheter radiofrequency ablation for ventricular tachycardia. National Institute for Health and Care Excellence (NICE), March 2009. www.nice.org.uk
- Ablation for cardiac arrhythmias. MSD manuals. www.msdmanuals.com, last full review/revision July 2019
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- Assessing fitness to drive: a guide for medical professionals. DVLA. www.gov.uk, last updated 26 September 2019
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Author information
Reviewed by Pippa Coulter, Freelance Health Editor, December 2019
Expert reviewer, Dr Tim Cripps, Consultant Cardiologist
Next review due December 2022
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