Sustained monomorphic ventricular tachycardia: Clinical manifestations, diagnosis, and evaluation
- Leonard I Ganz, MD, FHRS, FACC
Leonard I Ganz, MD, FHRS, FACC
- Section Editor — Cardiac Arrhythmias
- Director of Cardiac Electrophysiology
- Heritage Valley Health System
- Alfred Buxton, MD
Alfred Buxton, MD
- Professor of Medicine, Harvard Medical School
- Director, Clinical Electrophysiology Laboratory
- Beth Israel Deaconess Medical Center
Sustained monomorphic ventricular tachycardia (SMVT) is defined by the following characteristics:
●A regular wide QRS complex (≥120 milliseconds) tachycardia at a rate greater than 100 beats per minute
●The consecutive beats have a uniform and stable QRS morphology
●The arrhythmia lasts ≥30 seconds or causes hemodynamic collapse in <30 seconds
In patients with significant coronary heart disease (CHD) or other structural heart disease, a wide QRS complex tachycardia (WCT) should be considered to be ventricular tachycardia until proven otherwise. (See "Approach to the diagnosis of wide QRS complex tachycardias".)
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- EPIDEMIOLOGY AND RISK FACTORS
- CLINICAL MANIFESTATIONS AND ECG FINDINGS
- History and associated symptoms
- Physical examination
- DIFFERENTIAL DIAGNOSIS
- Supraventricular tachycardia
- Electrocardiogram artifact
- ADDITIONAL DIAGNOSTIC EVALUATION
- Cardiac imaging
- Continuous ECG monitoring
- Signal-averaged electrocardiogram
- Exercise testing
- Electrophysiologic studies
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS