Published 3 July 2008, doi:10.1136/bmj.39489.687894.DE
Cite this as: BMJ 2008;337:a424

Practice

Lesson of the Week

Slow ventricular tachycardia

¹ Praxis Leitz, Stuttgart, Germany, ² Royal-Berkshire Hospital, Reading, ³ Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX

A high index of suspicion for "slow ventricular tachycardia" is required in patients taking antiarrhythmic drugs

The first 150 words of the full text of this article appear below.

Ventricular tachycardias are commonly mistaken for supraventricular tachycardia with aberrant conduction. An incorrect diagnosis occurs in as many as 30% of cases.^{1 2} For patients prone to serious ventricular arrhythmias, antiarrhythmic drugs are frequently used, even in patients with devices such as an implantable cardioverter defibrillator, in whom slow ventricular tachycardia is more common than in the rest of the population.³ Such drug regimens commonly include amiodarone and β blockers, which may modulate the rate of any breakthrough ventricular rhythms to as low as 100-120 beats/min. Failure to recognise that patients have a persistent ventricular rhythm may have a deleterious effect on their haemodynamic status, with potential aggravation of symptoms of heart failure and further impairment of ventricular function. Such patients often have poor cardiac reserve, and minor deterioration in cardiac function can have serious consequences such as ventricular fibrillation, cardiac arrest, and sudden cardiac death.⁴ We report two cases where . . . [Full text of this article]

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