Khan Kashmala, Dimtri Francis, Vargas Carlos, Cuevas Christel, Alexander Thomas
Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.
Cardiology, Corpus Christi Medical Center, Corpus Christi, USA.
Cureus. 2020 Feb 5;12(2):e6888. doi: 10.7759/cureus.6888.
Ventricular tachycardia (VT) is characterized as a ventricular rhythm with a QRS >120 milliseconds (ms) and >100 beats-per-minute (BPM) in the absence of an aberrant conduction. It is classified as sustained when lasting >30 seconds. Risk factors associated with the development of VT include increasing age and coronary artery disease with concurrent left ventricular dysfunction, other forms of structural heart disease and acquired or congenital abnormalities in the cardiac sodium, potassium or calcium channels. Diagnosing VT is challenging based on history and physical exam alone. Combination of electrocardiogram (EKG), electrolytes and cardiac enzymes, echocardiogram, cardiac catheterization, and electrophysiology testing are required to appropriately diagnose and characterize the etiology. The case below describes an 84-year-old female with a known history of symptomatic bradycardia status post pacemaker who presented to the emergency department (ED) after a routine device check which revealed VT with associated dyspnea. The patient did not do well with medical therapy and required ablative therapy to resolve VT.
室性心动过速（VT）的特征是在无异常传导的情况下，心室节律的QRS波时限>120毫秒（ms）且心率>100次/分钟（BPM）。持续时间>30秒时被分类为持续性室性心动过速。与室性心动过速发生相关的危险因素包括年龄增长、伴有左心室功能不全的冠状动脉疾病、其他形式的结构性心脏病以及心脏钠、钾或钙通道的获得性或先天性异常。仅根据病史和体格检查诊断室性心动过速具有挑战性。需要结合心电图（EKG）、电解质和心肌酶、超声心动图、心导管检查以及电生理检查来准确诊断并明确病因。以下病例描述了一名84岁女性，有已知的症状性心动过缓病史，曾接受起搏器植入，在一次常规设备检查后出现室性心动过速并伴有呼吸困难，遂就诊于急诊科（ED）。该患者药物治疗效果不佳，需要消融治疗来消除室性心动过速。
