Ventricular tachycardia etiology

TABLE 6-10. Etiologies of Ventricular Tachycardia and Ventricular Fibrillation... 

Heart disease is the leading cause of death in the United States and is responsible for approximately 870,000 deaths per year (1). Sudden cardiac death (SCD) is responsible for almost half of these deaths, claiming 350,000 to 400,000 lives per year (2). SCD is defined by the World Health Organization as death due to any cardiac disease that occurs out of hospital, in an emergency room, or a patient who is dead on arrival to a care facility. Of note, the death must occur within one hour after the onset of symptoms. The majority of SCD is likely arrhythmic in etiology. In women, up to 88% of sudden cardiac arrests may be due to arrhythmic causes (3). Of SCD due to cardiac arrhythmias, greater than 80% of events are due to ventricular tachycardia (VT) and ventricular fibrillation (VF), with the remainder due to bradyarrhythmias and asystole (4). Coronary artery disease (CAD), manifesting acutely as ischemic ventricular arrhythmias or chronically as scar-mediated... 

Class I Indications for an ICD (1) Survivors of cardiac arrest secondary to ventricular tachycardia and ventricular fibrillation except when due to a reversible cause. (2) Sustained vaitricular tachycardia associated with structural heart disease. (3) Syncope of unclear etiology with an inducible ventricular tachycardia or ventricular fibrillation at electrophysiology study. (4) Nonsustained ventricular tachycardia in patients with coronary artery disease, left ventricular dysfunction, and inducible ventricular tachycardia or fibrillation at electrophysiology study that is not suppressed will by an antiarrhythmic drug. (5) Spontaneous sustained ventricular tachycardia in patients without structural heart disease who are not amenable to medical therapy. 

Carlson CA, Gravenstein JS, Gravenstein N. Ventricular tachycardia during ESWL etiology, treatment, and prevention. In Gravenstein JS, Peter K, eds. Extracorporeal Shock Wave Lithotripsy for renal stone disease Technical and clinical aspects. Boston Butterworth, 1986 119-123. 

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