Florida Hospital Cardiovascular Institute

What are the symptoms of ischemic ventricular tachycardia?Syncope, or fainting spell, is a common presentation for patients with this syndrome. In some patients, sudden cardiac arrest may be the first and only symptoms of these conditions. Yet other patients, there may be no symptoms at all or there may be vague symptoms such as shortness of breath or fatigue.What causes ischemic ventricular tachycardia?A prior heart attack, caused by the acute occlusion of one of the main coronary arteries (arteries that supply blood to the heart muscle), results in scar formation in the part of the heart supplied by that particular artery.  Over time, the border between the scar and healthy tissue (transitional zone) can allow electricity to go in and out of the scar (reentry), leading to incessant rapid heart beat.Consequences of ventricular tachycardia.This is a serious form of VT with presenting symptoms ranging from fainting spells to sudden cardiac arrest. If left untreated, this tachycardia is nearly universally fatal.Treatment OptionsWith rare exceptions, all patients with ischemic VT must be treated with an implantable defibrillator (ICD). Drug therapy with antiarrhythmic medications is no longer considered the standard of care as the failure rates for medications are unacceptably high (up to 50%).While ICD is the standard of care for ischemic VT, radiofrequency ablation may be a useful adjunctive therapy, especially in those patients whose VT recurs incessantly resulting in excessive number of ICD shocks.  The strategy in the ablation of this tachycardia is to create electrical isolation of the transitional zone in the ventricle where the electrical "circuit" of the VT resides.  This type of complex ablation will require specialized 3-D mapping system.