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Control of Ventricular Tachycardia

Richard H. Hongo

Richard H. Hongo, M.D., FACC

California Pacific Medical Center

Mills-Peninsula Medical Center

Sutter Pacific Medical Foundation

Question:

I was diagnosed with ventricular tachycardia a few years ago. I can usually keep it under control, except when I over exercise or if I've been stressed. Then my heart rate goes really up. Is there anything I can do to keep this from happening?

Answer:

Control of ventricular tachycardia depends a lot on the type of tachycardia that you have. Based on the fact you have had this for several years and have been controlling it without medications, you most likely have what we call idiopathic ventricular tachycardia. This tachycardia occurs most commonly because a spot in the muscle of your right ventricle (one of the lower chambers of the heart) is able to generate its own pulse. This spot gets excited by higher levels of adrenalin, and that is why it becomes more active when you are exercising or under more stress. Typically, it needs to be suppressed by medications and there are a number of fairly effective medications.

Another option is to get rid of the spot in the muscle with a procedure called catheter ablation. In this procedure, a thin flexible catheter is floated up from a large vein in the leg all the way up to the inside of your heart. Once inside the heart, the catheter is placed right on top of the problem spot in the muscle, and using the catheter, the tissue is gently heated up to 60-degrees C. This will denature the tissue and a permanent scar will form, curing the problem in over 90 percent of cases.

Ventricular tachycardia comes in many forms. There are types of ventricular tachycardia that can be life-threatening. It does not sound like you have a dangerous type of ventricular tachycardia but it is important that you have your doctor follow this closely. If you haven't seen your doctor recently, I would make an appointment and have your doctor discuss the possibility of either medications or catheter ablation to better control your episodes.

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