Ventricular tachycardia occurs when the bottom chambers independently beat faster than the top chambers in a fast but regular pattern. 3 or more consecutive ventricular beats is considered ventricular tachycardia, and if persists can decrease the amount of blood to fill the ventricles and subsequently decrease the amount of oxygenated blood delivered to the brain and body. Ventricular tachycardia may occur in children with normal hearts, cardiac genetic diseases, and those with heart disease.

 

Signs and symptoms:

Symptoms are often associated with how fast or slow the ventricular tachycardia rate. Many, but not all, patients experience symptoms with ventricular tachycardia. Common symptoms for ventricular tachycardia include fainting, lightheadedness, dizziness, shortness of breath, chest pain, and/or palpitations (heart racing, skipping, or fluttering feelings). Younger children may have a hard time verbalizing their symptoms but sometimes use words such as “heart beeping” to describe a funny feeling.

 

Diagnosis:

When there is a suspicion that a child may be having ventricular tachycardia your Cardiology/Electrophysiology team may order testing. Some of the tests that may be ordered are (see Basic EP fact sheet for more details):

• ECG: an electrocardiogram is a quick, easy test in which stickers or electrodes are placed over the child’s chest and body. The test shows the hearts electrical activity and rhythm as tracings on paper.

• Holter Monitor: a device that records continuous rhythm strips of the heart for 24-72 hours. The child wears the monitor with 3-4 electrodes that connect to the monitor which is about the size of a deck of cards. This test is good for patients who have symptoms daily.
• Event Monitor: similar to a Holter monitor, however this will give single lead rhythm strips with two big differences. An event monitor is typically worn for 30 days. Additionally, the event monitor may only record when the child has a symptom and pushes a button on the monitor to tell it to record.
• Exercise Stress Test:  a test performed on a stationary bicycle or treadmill according to a protocol. During the test, an ECG is continually monitored, and blood pressures are frequently checked.
• Echo: an ultrasound of the heart to identify the structural of the heart and the function of the heart (how well the heart muscle squeezes).

 

Treatment:

Treatment options may include lifestyle changes, medications, ablation, device implantation, cardiac surgery. Your cardiologist will discuss the treatment options with you.

• No medical management, with close surveillance
• Medications may include beta blockers, calcium channel blockers, sometimes combination therapy with other antiarrhythmic medication is needed.
• Cardioversion: Performed under sedation, an electrical discharge through patches placed on the chest to convert the abnormal heart rhythm to normal to a normal rhythm.

• Ablation (see Basic Electrophysiology fact sheet).
  • The Procedure is done in the Cardiac Cath or the Cardiac Electrophysiology Lab.
• Implantable Cardioverter Defibrillator (ICD) (see ICD/Pacemaker overview)
• Arrhythmia Surgery: May be used when all other treatments have been unsuccessful or used in combination with cardiac surgery for children with congenital heart disease.

 

Lifestyle changes:

Modifying your child’s lifestyle or diet

 

Activity restrictions will be based upon the cause and the treatment of the ventricular tachycardia. Your healthcare team will help guide you in the decision-making process. Even if there are some restrictions, it will be important to discuss the activities that are safe and appropriate for the patient, and to focus on what CAN be done!