Vtách

Vtách, often abbreviated VTach in English-language medical literature, refers to a ventricular tachycardia, a rapid heart rhythm that begins in the heart's lower chambers. It is defined as a sustained fast heart rate, typically above 100 beats per minute, with wide QRS complexes on the electrocardiogram, lasting longer than 30 seconds or causing hemodynamic instability. Vtach can be monomorphic, with a uniform QRS shape, or polymorphic, where the morphology changes over time.

Most cases occur in people with structural heart disease, especially after myocardial infarction or in cardiomyopathy, but it can also result from electrolyte disturbances, drug toxicity, congenital channelopathies, or as a result of ischemia in patients without prior disease.

Symptoms range from palpitations and lightheadedness to dizziness, syncope, chest pain, or shortness of breath. Some episodes are asymptomatic and detected on ECG or during monitoring. Diagnosis rests on electrocardiography showing a wide-complex tachycardia; distinguishing VTach from supraventricular tachycardia with aberrancy may require clinical judgment and, at times, imaging to assess cardiac structure.

Acute management focuses on stabilization and rhythm control. If the patient is unstable, synchronized cardioversion is performed promptly. If stable, intravenous antiarrhythmics such as amiodarone or lidocaine are commonly used, with consideration of underlying causes and possible revascularization if coronary disease is present. Long-term strategies include treating the underlying heart condition, medication-based rate control and antiarrhythmics, catheter ablation for recurrent focal VT, and implantable cardioverter-defibrillators in selected patients at risk of sudden death.

The prognosis depends on the underlying cardiac condition and the VT's duration and recurrence; timely treatment improves outcomes.