Sustained monomorphic ventricular tachycardia: Diagnosis and evaluation
- Philip J Podrid, MD, FACC
Philip J Podrid, MD, FACC
- Professor of Medicine, Professor of Pharmacology and Experimental Therapeutics
- Boston University School of Medicine
- Lecturer, Harvard Medical School
Sustained monomorphic ventricular tachycardia (SMVT) is a potentially life-threatening arrhythmia which can be differentiated from supraventricular tachycardia, nonsustained ventricular tachycardia, and polymorphic ventricular tachycardia by the following characteristics:
●Wide QRS complex tachycardia (WCT) with QRS complex duration >0.12 seconds and a rate of greater than 100 beats per minute
●Atrioventricular (AV) dissociation
●Uniform and stable QRS morphology, although there may be subtle changes in QRS complex morphology and in the ST-T waves
●Duration of at least 30 seconds or development of hemodynamic compromise
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- EPIDEMIOLOGY AND RISK FACTORS
- CLINICAL EVALUATION
- Physical examination
- Drug use
- DIAGNOSTIC EVALUATION
- Establishing underlying heart disease
- - Cardiac imaging
- - Signal-averaged electrocardiogram
- - Exercise testing
- Continuous ambulatory and event monitoring
- Electrophysiologic studies
- DIFFERENTIAL DIAGNOSIS
- Supraventricular tachycardia
- Electrocardiogram artifact
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS