Management of Ventricular Tachycardia and Ventricular Fibrillation

Abstract

Abstract While intraoperative arrhythmias are common, ventricular tachycardia and ventricular fibrillation are potentially life-threatening arrhythmias that originate in ventricular structures. Ventricular tachycardia is defined as three or more consecutive ventricular premature contractions (VPCs) with a rate of at least 100 beats per minute, and may present with stable or unstable physiology. It is considered sustained if it persists for at least 30 seconds. Stable or asymptomatic ventricular tachycardia affords the caregiver time for diagnosis, consultation, and formulation of a treatment plan, while unstable or symptomatic ventricular tachycardia requires emergent intervention. Unstable ventricular tachycardia is diagnosed by signs of decreased cardiac output and will typically present with a heart rate of at least 150 beats per minute. Ventricular fibrillation and pulseless ventricular tachycardia should be treated immediately with defibrillation and advanced cardiac life support (ACLS) to try to achieve return of spontaneous circulation (ROSC).