Ventricular tachycardia

Your health expert: Dr Tim Cripps, Consultant Cardiologist
Content editor review by Victoria Goldman, Freelance, March 2022
Next review due March 2025

Ventricular tachycardia is a type of abnormal heartbeat called an arrhythmia. It means your heart is beating too quickly and isn’t pumping enough blood around your body.

What happens in ventricular tachycardia?

Your heartbeat is controlled by electrical signals (impulses). These signals travel through your heart and make it contract. If you have 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. Even though your heart may be beating faster, it’s not pumping blood so well. This is because your ventricles are beating too quickly so they may not have enough time to fill up with blood between beats. This means your heart can’t pump enough blood to the rest of your body.

Most people who get ventricular tachycardia already have some problems with their heart, such as a previous heart attack or heart muscle disease (cardiomyopathy).

Attacks of ventricular tachycardia can sometimes stop on their own after a few seconds. This is called non-sustained ventricular tachycardia. If the attack carries on for longer than 30 seconds, this is called 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.

Causes of ventricular tachycardia

Ventricular tachycardia usually happens in people who have already had significant problems with their heart.

This may be:

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 medicines
physical or mental stress
too much caffeine
illegal drugs such as cocaine
imbalances of certain chemicals in your blood (such as too little potassium, calcium or magnesium)

Symptoms of ventricular tachycardia

If you have brief episodes of ventricular tachycardia that stop on their own, you may not get any symptoms at all. But 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 (fainting)

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.

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 a monitor outside your body, you may have an implantable loop recorder. This is a small device that’s 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. These tests 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 these are 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.

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Treatment of ventricular tachycardia

The treatments for ventricular tachycardia aim to stop the attack, get your heart back to a normal rhythm and prevent any more 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 such as high blood pressure, your doctor will treat that too.

Stopping an attack

If ventricular tachycardia causes your heart to stop (a cardiac arrest), you’ll need immediate defibrillation (electric shock treatment). You’ll also need cardiopulmonary resuscitation (CPR) to re-start your heart.

If you don’t need defibrillation 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 like defibrillation, but the electrical burst can be timed.
Antiarrhythmic medicines such as amiodarone through a drip in your arm.
Overdrive pacing. A thin tube is put 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 could keep having ventricular tachycardia attacks, they’ll offer you treatment to help prevent or stop more attacks. The treatment you’re offered will depend on your circumstances. Your doctor will discuss your options with you. You may be offered one or more of the following.

Implantable cardioverter defibrillator (ICD)

Most people who have previously had a ventricular tachycardia attack without 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 going into your heart. It can detect when an attack of ventricular tachycardia is starting and then delivers electrical pulses or shocks to restore your heartbeat to normal.

A shock from an ICD 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. If someone is touching you when your ICD delivers a shock, they’ll notice the jolt and may feel a tingling sensation. But don’t worry – it won’t harm them.

If you get a single shock and no associated symptoms, you’ll usually need to follow up with your ICD centre as soon as possible. Follow the advice given to you by your clinic because 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 gave you a shock.

You’ll usually have check-ups every three months or so to check how well your ICD is working. If doing well, your check-ups may be once a year. Some types of ICD allow your clinic to monitor the effect remotely using software installed in your home.

Medicines

You may be prescribed medicines instead of or as well as having 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. Ablation uses radiofrequency energy to destroy the tissue in your heart that's disrupting or causing abnormal electrical signals.

You may have:

a catheter ablation: a thin tube (an electrode catheter) is passed up to your heart through a vein in your groin
an epicardial ablation: the catheter is passed through the skin of your chest and into the outer layer of your heart wall

Lifestyle changes

Your doctor may also advise you to make some lifestyle changes to reduce your risk of more ventricular tachycardia 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 important if you have ventricular tachycardia. Giving up smoking can reduce your risk of sudden cardiac death from ventricular tachycardia.

Driving with ventricular tachycardia

If you have ventricular tachycardia, you shouldn’t drive for at least four weeks if your symptoms could affect your ability to drive safety. These include dizziness and fainting. If this is the case, you should let the Driver and Vehicle Licensing Agency (DVLA) know. The DVLA provides advice and information about driving with health conditions.

If your ventricular tachycardia has been controlled for at least four weeks, you should be able to start driving again. But speak to your doctor first. You’ll also need to check when you can drive after having certain procedures, such as catheter ablation or an implantable cardioverter defibrillator (ICD) fitted.

The rules about driving are different if you have an arrhythmia and drive a lorry or are responsible for passengers. You’ll need to speak to your doctor and check the DVLA’s advice for your condition.

Complications of ventricular tachycardia

It’s important to get treatment for ventricular tachycardia straightaway. If an attack lasts for a long time or is very fast and isn’t treated quickly, it can cause ‘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. It causes an extremely fast, life-threatening heart rhythm. Your heart then can’t beat properly, which means it pumps out little or no blood. 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.

Ventricular tachycardia is most common in people who already have a heart problem such as coronary artery disease, a previous heart attack or heart muscle disease (cardiomyopathy). But there are other possible causes too. For more information, see our section on causes of ventricular tachycardia.

Lots of people live with ventricular tachycardia. They may need to take medicines to control their heart rhythm. Or they may have an implantable cardioverter defibrillator (ICD) fitted to restore their heartbeat to normal during an attack. For more information, see our section on treatment of ventricular tachycardia section for more information.

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Ventricular tachycardia

What happens in ventricular tachycardia?

Heart arrhythmias - ventricular tachycardia