Ventricular arrhythmias are abnormal heart rhythms that originate in the bottom chambers of the heart called the ventricles. Ventricular arrhythmia may cause:
- Heart attack
- Heart failure
- Sudden death
Sometimes problems with the heart's electrical signals lead to a fast heart rhythm. Too many signals may make the heart beat very fast (tachycardia). Or signals may be sent so rapidly and irregularly that the heart muscle sometimes quivers and doesn't beat at all (fibrillation).
Types of Ventricular Arrhythmias
There are several types of ventricular arrhythmia. They include:
- Ventricular tachycardia (VT): With VT, abnormal electrical pathways or circuits develop in the ventricles, usually in an area of heart muscle that's been damaged by heart attack or disease. Electrical signals enter the abnormal circuit and loop around, each time telling the ventricles to contract. This makes the heart beat very fast. VT can sometimes develop into the most serious arrhythmia, ventricular fibrillation.
- Ventricular fibrillation (VF): With VF, the ventricles contain many abnormal circuits. These are usually due to damaged heart muscle. When signals enter the circuits, the ventricles beat very quickly and irregularly, so the heart muscle can't pump effectively. If the heart gets to the point that it can't pump at all (cardiac arrest), death may occur if emergency treatment isn't given to return the heart rhythm to normal.
- Supraventricular arrhythmia: A supraventricular (meaning above the ventricles) arrhythmia is a less serious condition occurring in the atria.
- Brachycardia: A brachycardia is an abnormally slow heart rate. Two examples of brachycardias are
- Sick Sinus Syndrome, which occurs when the heart's sinus node or another part of its electrical conduction system isn't working correctly.
- Heart Block, which is often caused by a congenital heart defect, although it can also result from disease or injury.
Symptoms of Ventricular Arrhythmia
Some people do not experience any symptoms. However, symptoms of a ventricular arrhythmia may include:
- Chest pain
- Fast or slow heartbeat (palpitations)
- Light-headedness, dizziness
- Shortness of breath
- Changes in the pattern of the pulse (skipping beats)
Diagnosing Ventricular Arrhythmia
The doctor will listen to your heart with a stethoscope and feel your pulse. Your blood pressure may be low or normal. The following tests may be performed to identify arrhythmias:
- Ambulatory cardiac monitoring with a Holter monitor (used for 24 hours), event monitor or loop recorder (worn for 2 weeks or longer)
- Coronary angiography
- Electrophysiology study (EPS)
If an arrhythmia is detected, various tests may be done to confirm or rule out suspected causes. EPS testing may be done to find the arrhythmia and determine the best treatment, especially if a pacemaker or catheter ablation procedure is being considered.
Treating Ventricular Arrhythmia at St. Joseph's Heart & Vascular Institute
Urgent treatment may be required in some cases to restore a normal rhythm. This may include:
- Defibrillation or cardioversion (electrical "shock" therapy)
- Implanting a temporary pacemaker to interrupt the arrhythmia
- Intravenous medications
Some medications that may be used are:
- Beta blockers or calcium channel blockers to slow the pulse
- Anti-arrhythmic drugs that cause the heart rhythm to return to normal
Many supraventricular arrhythmias can be treated and cured with radiofrequency ablation which avoids the need for lifelong drug therapy.
VTs can be treated with an implantable cardioverter defibrillator (ICD) or with VT ablation.
Managing Ventricular Arrhythmia
Taking the following steps to prevent coronary artery disease may prevent the development of an arrhythmia:
- Eating a well-balanced, low-fat diet
- Exercising regularly
- Not smoking
At the Morrissey Family Heart & Vascular Institute, we offer a number of preventative health programs and tools for our patients. Find out more about how we can help you Stay Heart Healthy.
The likelihood of recovery from ventricular arrhythmia depends on several factors:
- The kind of arrhythmia
- The overall pumping ability of the heart
- Whether you have heart disease and how well it can be treated
- Some types of arrhythmias may be life-threatening if not promptly and properly treated. With brachycardias treated with a permanent pacemaker, the outlook is usually good.