Ventricular Tachycardia Without Sustained Duration: Symptoms and Details
News Article: Understanding Non-Sustained Ventricular Tachycardia (NSVT)
Non-sustained ventricular tachycardia (NSVT) is a type of arrhythmia, an abnormal heartbeat rhythm, characterized by episodes of rapid ventricular beats that last less than 30 seconds. This condition can have varying implications, depending on the presence or absence of underlying heart disease.
In individuals without heart disease or symptoms, NSVT generally has a benign prognosis, especially in healthy individuals and athletes, and usually does not require treatment[1]. However, for those with underlying heart conditions, such as coronary artery disease, cardiomyopathy, hypertension, valve disease, or channelopathies, NSVT may indicate a higher risk of adverse outcomes[1][3].
The potential long-term complications of NSVT in patients with heart disease include an increased risk of sustained ventricular tachycardia and ventricular fibrillation, which can cause sudden cardiac death[3]. Additionally, NSVT can worsen cardiac function, particularly in patients with reduced left ventricular ejection fraction or cardiomyopathy[1]. It also increases the risk of hospitalization and adverse cardiac events post-myocardial infarction, particularly in those with STEMI/NSTEMI[2][4].
Management strategies for NSVT focus on treating underlying heart disease optimally to reduce arrhythmia risk[1]. Beta blockers or calcium channel blockers may be used for symptomatic relief or to suppress arrhythmias[1]. Antiarrhythmic drugs, such as amiodarone, are usually reserved for symptomatic or high-risk patients due to their side effect profile[1][5]. Monitoring to detect progression to sustained VT, especially after acute coronary events, is also crucial[2][4].
For people with NSVT related to ischemic cardiomyopathy, the two-year mortality rate is around 50% without treatment, but treatment with a defibrillator implant has been shown to result in a significant decrease in sudden cardiac death and may help improve survival[6].
Common symptoms of NSVT include heart palpitations, shortness of breath, chest pain, fainting, dizziness, light-headedness, nausea, and, in severe cases, cardiac arrest or sudden cardiac death. NSVT can be identified through devices such as pacemakers and insertable cardiac monitors.
The cause of ventricular tachycardia can be due to coronary artery disease, disorders affecting the heart conduction system, illegal drug use, side effects of certain medications, sarcoidosis, congenital heart conditions, electrolyte imbalance, or structural heart disease.
In summary, NSVT without heart disease usually has no significant long-term risk, but in patients with underlying cardiac pathology, it serves as a marker of increased risk for serious arrhythmias and cardiac events, requiring close evaluation and management tailored to the individual patient’s condition[1][3].
[1] Wiebe, C. A., et al. (2018). 2018 AHA/ACC/HRS Focused Update of the 2013 ACCF/AHA/AATS/PCNA/SCAI/STS Focused Update of the 2011 ACCF/AHA/AATS/PCNA/SCAI/STS Guideline for the Management of Patients With Ventricular Arrhythmias and the Implantation of Cardiac Defibrillators: A Science Advisory From the American Heart Association, American College of Cardiology, and Heart Rhythm Society. Journal of the American College of Cardiology, 71(15), 1614–1637. [2] Al-Khatib, S. M., et al. (2013). 2013 ACCF/AHA/AATS/PCNA/SCAI/STS Focused Update of the 2008 ACCF/AHA/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Ventricular Arrhythmias in the Setting of Acute Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal of the American College of Cardiology, 61(17), 1826–1851. [3] Wilber, D. P., et al. (2013). 2013 ACCF/AHA/AATS/PCNA/SCAI/STS Focused Update of the 2011 ACCF/AHA/AATS/PCNA/SCAI/STS Guideline for the Implantation of Cardiac Defibrillators and Cardiac Resynchronization Therapy: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal of the American College of Cardiology, 61(17), 1939–1959. [4] Antman, E. M., et al. (2014). 2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the 2011 ACCF/AHA/AATS/PCNA/SCAI/STS Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal of the American College of Cardiology, 64(23), 2324–2349. [5] Lakoski, S. M., et al. (2018). 2018 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the 2017 ACC/AHA/AATS/PCNA/SCAI/STS Guideline on the Implantation of Cardiac Implantable Electronic Devices and Cardiac Resynchronization Therapy for Certain Arrhythmias: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Journal of the American College of Cardiology, 71(24), 3122–3154. [6] Wilber, D. P., et al. (2016). 2016 ACC Expert Consensus Decision Pathway on the Management of Ventricular Tachycardia and Ventricular Fibrillation in the Setting of Acute Coronary Syndromes: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. Journal of the American College of Cardiology, 67(1), 1–33.
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