Kammiotakykardia

Kammiotakykardia is the Finnish term for ventricular tachycardia, a fast heart rhythm that originates in the ventricles. It is defined as a tachycardia with a rate typically between 100 and 250 beats per minute and a wide QRS complex on the surface ECG. Sustained ventricular tachycardia lasts at least 30 seconds or causes hemodynamic instability; non-sustained VT is shorter and may be self-limited.

VT is classified by QRS morphology into monomorphic VT, with a uniform QRS shape, and polymorphic VT, where morphology changes over time.

Common causes include ischemic heart disease and prior myocardial infarction with scar tissue, cardiomyopathies, electrolyte disturbances (notably hypokalemia and hypomagnesemia), structural heart disease, drug toxicity, and inherited channelopathies. Acute triggers can include acute coronary syndromes and myocarditis.

Clinically, patients may experience palpitations, dizziness, chest pain, or syncope. In unstable VT, there may be hypotension or altered mental status. VT can deteriorate into ventricular fibrillation if not treated promptly.

Diagnosis relies on the ECG showing a wide-complex tachycardia. Further evaluation may include echocardiography to assess heart structure, laboratory tests for electrolytes and toxins, and imaging or coronary studies to identify underlying disease.

Management depends on stability. In hemodynamically unstable VT, immediate synchronized cardioversion is indicated. In stable monomorphic VT, intravenous amiodarone is often first-line, with lidocaine or procainamide as alternatives. Magnesium is used for torsades de pointes. Treat underlying causes, including ischemia or electrolyte imbalances. For recurrent VT or structural heart disease, catheter ablation and/or implantable cardioverter-defibrillator therapy may be considered.

Prognosis varies with the underlying heart condition and VT burden. Kammiotakykardia signals an elevated risk of adverse outcomes, but appropriate therapy can improve survival and quality of life.