Ventricular Tachycardia

Summary

Ventricular tachycardias in the young are a diverse group of rhythm disorders different than those seen in the adult with ischemic heart disease. There are not only a wide variety of ventricular substrates but also a variety of electrophysiologic mechanisms. The ability of many young patients to tolerate VT allows the clinician to approach the arrhythmia in a deliberate fashion. On the other hand, VT remains an important cause of sudden death in the young and identifying diagnostic possibilities for sudden death in a patient presenting with VT requires a consideration of a variety of diagnostic and treatment strategies. In many young patients, VT, that so often in adults is associated with risk of sudden death, may spontaneously remit. However, ventricular tachycardia after surgery for congenital heart disease calls for a comprehensive evaluation based on a complete understanding of the clinical state of the patient, the natural history of the arrhythmia, the cardiac anatomy, the surgical history, and the electrophysiologic properties of the arrhythmia.