Obligatory medical device diagnostics.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) [Ventricular tachycardia (VT): wide-complex tachycardia (heart rate > 120/min; QRS complex: duration ≥ 120 ms);
- Monomorphic VT – in ischemic cardiomyopathy/cardiomyopathy with reduced blood flow to the myocardium and after myocardial infarction/heart attack; dilated cardiomyopathy/diseased dilatation of the myocardium, especially of the left ventricle]
- Monomorphic VT with specific morphology.
- Outflow tract VT: origin is a focal focus in the outflow tract of one of the ventricles (heart chamber); occurrence in mostly heart-healthy patients; usually not life-threatening; often oligosymptomatic (only symptom)
- Fascicular VT: QRS block only borderline wide and right bundle branch block; occurrence in mostly cardiac healthy patients.
- polymorphic VT
- Torsade de Pointes (TdP) in congenital or acquired long QT syndrome (LQTS; prolongation of QT time on ECG).
- Brugada syndrome (BS) – is classified as a “primary congenital (congenital) cardiomyopathy” and there as a so-called ion channel disease. Patients with this disorder appear to be completely heart healthy, but can suffer sudden cardiac death in adolescence and early adulthood. Long-QT syndrome (prolongation of the QT time in the electrocardiogram (ECG); can lead to sudden cardiac death in otherwise heart-healthy people)]
Notice:
- In the 12-lead ECG, ventricular tachycardia (VT) can never be reliably differentiated from supraventricular tachycardia (SVT) in the presence of preexcitation or aberration → In an emergency situation, therefore, always tend to assume VT!
- Patients with hemodynamically relevant wide-complex tachycardia and > 35 years with previous cardiac disease have a high pretest probability of VT.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Long-term ECG (ECG applied over 24 hours) – for more accurate assessment of cardiac function within the day.
Note: Tachycardia with a widened QRS complex is found in:
- Ventricular tachycardia (VT; ventricular tachycardia).
- Supraventricular tachycardia (SVT) with a thigh block (preexisting or tachycardia related) about 30% of all SVT).
- Antegrade conduction via an accessory bundle or retrograde with bundle branch block (rare).
- Electrolyte disturbance(s) or medications that widen SVT (very rare).
