Ventricular Tachycardia

Medically Reviewed by Zilpah Sheikh, MD on February 15, 2024
Written by Keri Wiginton, Kristin Mitchell, WebMD Editorial Contributor
11 min read

Ventricular tachycardia is a type of arrhythmia, or irregular heart rhythm. Sometimes called VT or V-tach, it’s an unusually fast heartbeat that starts in the lower part of your heart called the ventricles. 

What is a normal heartbeat?

Your heart is a muscular pump with four chambers. The two upper ones are called the atria. The two lower ones are called the ventricles. They work together to pump blood throughout your body. Every day, a healthy heart beats about 100,000 times.

Most regular heart rates are in the range of 60 to 100 beats a minute.

Your heartbeat follows a pattern that is controlled by electrical signals. They start in the sinoatrial (SA) node. It’s in one of your atria and is often called your heart’s natural pacemaker.  

The signal causes your atria to contract so blood moves into your ventricles. It then moves down to another part of your heart called the atrioventricular (AV) node. This tells your ventricles to contract and move the blood along.

What happens in ventricular tachycardia?

When you have VT, abnormal electrical signals from your ventricles take over and make your heart beat quickly. The pulses coming from your SA node are also affected.

Ventricular tachycardia can result in rates of 120 to 170 beats a minute or even more.

When this happens, your heart’s upper chambers don’t have time to refill and send that blood to the ventricles. So your blood doesn’t get pumped throughout your body the way it should. 

Ventricular tachycardia vs. ventricular fibrillation 

In some instances, ventricular tachycardia can lead to ventricular fibrillation. Sometimes called V-fib or VF, this condition also causes a fast heart rate. But with VF, the heart muscle shakes instead of following a regular pattern. If left untreated, V-fib can prevent blood flow to the rest of your body. Your heart may stop within a few minutes.

Here are some common terms used to describe ventricular tachycardia: 

Monomorphic ventricular tachycardiaMonomorphic ventricular tachycardia describes how your heart rhythm looks more steady from beat to beat when your doctor checks the electrical activity with an electrocardiogram (EKG). “Mono” means each heartbeat “wave” looks the same on the machine. Around 70% of all VT episodes are this kind. 

Polymorphic ventricular tachycardia

This type of VT is a very dangerous type of arrhythmia. The “poly” part means your heart’s electrical activity is all over the place. You may need a different type of medication or treatment depending on the type of polymorphic VT you have. 

Nonsustained ventricular tachycardia

Nonsustained ventricular tachycardia refers to when VT lasts less than 30 seconds. These episodes may come and go, which can make it harder to diagnose at the doctor’s office. 

Sustained ventricular tachycardia

Sustained VT is when you have a VT episode for 30 seconds or longer or it causes a problem, like a sudden drop in blood pressure, that needs treatment.  

Pulseless ventricular tachycardia

This type of VT means your ventricles beat so fast they can’t fill with blood to send to the rest of your body. You won’t have a pulse if your heart can’t sustain normal blood flow. This can happen whether you have monomorphic VT or polymorphic VT. 

You may not notice any symptoms, especially if your heart beats fast for only a few seconds, but ventricular tachycardia can cause:

Ventricular tachycardia may cause a sudden drop in blood pressure, which means your tissue and organs can’t get enough oxygen. You might pass out when this happens, but your heart may stop. This is called sudden cardiac arrest, and can be fatal.  

When should I call a doctor?

Get in touch with your medical provider if you have an increase or change in your regular heart rate and don't know why. 

Call 911 or go to the hospital right away if you or a loved one have emergency signs or symptoms of ventricular tachycardia, especially: 

  • Chest pain
  • Trouble breathing
  • Loss of consciousness
  • Fast or abnormal heartbeat that lasts longer than 30 seconds
  • Loss of pulse

See your doctor as soon as possible if you’ve felt lightheaded or dizzy, had rapid heartbeats, or have fainted.

Call 911 if you have chest pain and trouble breathing along with a very fast pulse.

Ventricular tachycardia happens when there’s a glitch in your heart’s electrical system. These abnormal signals trigger the fast rhythm in your ventricles that revs up your heart rate.

You’re more likely to have ventricular tachycardia if you’re older or if heart rhythm problems run in your family. That includes conditions you can inherit from your parents like long QT syndrome or Brugada syndrome.   

Conditions that can cause problems with the signals in your heart that lead to ventricular tachycardia or raise your chances of it also include:

  • Prior heart attack
  • Heart failure 
  • Weak heart muscle (cardiomyopathy)
  • Conditions that scar your heart (sarcoidosis)
  • Blood flow issues from heart disease
  • Electrolyte imbalance, especially abnormal levels of potassium and magnesium
  • Inflammation of your heart muscle (myocarditis)
  • Sarcoidosis, a condition that causes inflamed tissues to grow in your body
  • Conditions that change the pH in your cells (acidosis)
  • Stimulants like cocaine or methamphetamine
  • Heavy alcohol use or caffeine
  • Recreational drugs
  • Certain medications

When doctors can’t find a cause, it’s called idiopathic ventricular tachycardia.

Your doctor will review your medical history and ask about your symptoms. They’ll also run some tests on your heart, which usually includes an electrocardiogram (EKG or ECG). An EKG records your heart’s electrical activity. 

Other tests used to diagnose ventricular tachycardia include: 

Holter monitor. This is a portable device you wear outside of the doctor’s office. It can check your heart’s electrical activity off and on throughout the day. Your doctor might suggest this if they think you have ventricular tachycardia but your EKG is normal. 

Event monitor. This is another portable EKG you use outside of the doctor’s office. Your doctor may have you wear one for up to 30 days or until you have an irregular heart rhythm. 

Implantable loop recorder. Your doctor may put a small device under your skin. This can monitor your heartbeat on a regular basis for up to 3 years. 

Imaging tests (X-ray, MRI, CT, echocardiogram). These tests take a closer look at your heart to show how well it works or if you have structural problems. 

Coronary angiogram. This can check for blocked arteries that may cause blood flow problems. 

Stress test. Your doctor may give you medicine or have you exercise (ride a bike, walk on a treadmill) to see if physical activity affects your heart’s electrical activity. 

Tilt table test. If you faint a lot, your doctor may have you lie on a special table. They’ll move you from flat to upright to see how your heart and blood pressure react to certain situations (like when you go from sitting to standing).  

Electrophysiological test. Your doctor may thread small wires and sensors through a big blood vessel into your heart. This can pinpoint problem areas that cause your irregular heartbeat.

Transesophageal echocardiography. This can check the size and shape of your heart and look for other problems, including certain blood flow issues. 

Blood tests. These can check for other health problems that may affect your heart, including an electrolyte imbalance or problem with your thyroid hormone. 

You may not need to do anything if you don’t have symptoms or if episodes last less than 30 seconds. Otherwise, your treatment will depend on what’s causing the problem. For example, if medication or stimulants like caffeine are causing episodes of ventricular tachycardia, you’ll probably have to stop using them.

What are the treatments for ventricular tachycardia?

Depending on serious your symptoms are, you may need : 

  • Cardioversion. Your doctor uses an electric shock to return your heart to its regular rhythm. This is a common emergency treatment, especially if VT happens along with fainting or low blood pressure.
  • Medications to control yourheart rate.This includes antiarrhythmic medications such as amiodarone (Nexterone, Pacerone), flecainide (Tambocor), lidocaine (Lidopen), propafenone (Rhythmol SR), or sotalol (Betapace, Sotylize). Your doctor may also give you drugs called beta-blockers that block chemicals that speed up your heart. These don’t work as well as cardioversion, and they can have side effects. 
  • Cardiac resynchronization therapy (CRT). Your doctor implants a small pacemaker  near your collarbone that regulates the electrical signals in your ventricles.. 
  • An implantable cardioverter-defibrillator (ICD). This is a small device placed under the skin just below your collarbone. You may get it along with CRT. An ICD delivers a shock to reset your heartbeat if it becomes uneven. It’s the most effective way to prevent life-threatening problems (like sudden cardiac death) from ventricular tachycardia.
  • Cardiac ablation. This is also called catheter or radiofrequency ablation. Doctors use heat to destroy unusual heart tissue. This method treats the ventricular tachycardia and can cure it. 
  • Maze procedure. Your doctor may give you a type of surgery where they make small cuts in the top part of your heart. This creates a pattern (or maze) of scar tissue that abnormal electrical signals can’t get through.   
  • Open-heart surgery. In some cases, your doctor may be able to get rid of or fix whatever is causing your fast heartbeat. This is usually only recommended if nothing else helps or you have another type of heart problem that needs treatment. 

 All medical procedures come with risks. But surgeries for ventricular tachycardia, such as cardiac ablation, may cause complications, including: 

  • Heart and blood vessel damage
  • Blood clots
  • Increased bleeding
  • Exposure to germs during surgery that cause infection

If you have cardiac ablation, you’ll probably need to stay in the hospital overnight. You may be able to get back to normal life within a few days, but ask your doctor how long you’ll need to take it easy.  

If a medication or caffeine is causing the VT, you might need to stop taking it.

Your treatment plan depends on what’s causing your irregular heart rhythm. But here are some steps you can take to manage ventricular tachycardia: 

  • Take any medication your doctor gives you to regulate your heart rate.
  • Get an ICD if your doctor thinks you need one.
  • Work with your medical team to create a safe exercise plan.
  • Keep track of your symptoms and tell your doctor if you notice any changes.
  • Get treatment for any other health conditions.
  • Follow a heart-healthy diet (low in saturated fat, salt and added sugar).
  • Don’t smoke.

It’s important to seek treatment if you have an irregular fast heartbeat. While ventricular tachycardia may not always be dangerous, it can cause serious problems if it happens often or for longer than 30 seconds. Your odds of complications also go up if you have other heart problems. 

If your heart can’t get blood flow to the rest of your body, you may: 

  • Faint a lot
  • Lose consciousness 
  • Have sudden drops in blood pressure
  • Develop heart failure
  • Get ventricular fibrillation
  • Go into sudden cardiac arrest, which can be fatal

You may not be able to completely prevent ventricular tachycardia, but there are steps you can take to lessen your chances of it happening. You’ll want to focus on heart-healthy habits including: 

  • Eat mostly fruits, vegetables, whole grains, unsaturated fats, and lean proteins.
  • Limit foods high in sugar, salt, and saturated fat.
  • Aim for 30 minutes of cardio most days of the week. 
  • Try yoga.
  • Lose excess body weight if you’re overweight or have obesity. 

You’ll also want to: 

  • Be careful with stimulants like caffeine.
  • Find ways to manage stress. 
  • Try to get 7 to 9 hours of sleep a night. 
  • Drink alcohol in moderation or not at all. 
  • Quit smoking or don’t start.
  • Avoid recreational drugs such as cocaine or methamphetamines. 

And make sure you talk to your doctor about: 

  • How to maintain the right balance of electrolytes like potassium and magnesium 
  • Ways to control your blood pressure and cholesterol levels
  • If you need to manage thyroid disorders or kidney disease 
  • Which prescription or over-the-counter medications are safe
  • Any heart conditions that need treatment 

There may be other ways to lessen your chances of triggering an irregular heart rhythm. Ask your medical team for more tips. 

Ventricular tachycardia is a type of arrhythmia that causes your heart to beat faster than normal. Episodes that last longer than 30 seconds can be deadly. Treatment with medication, devices, or surgery can restore your regular heartbeat or prevent VT from happening again.  

What is the best treatment for ventricular tachycardia?

It depends on what’s causing it and how long it’s lasted. In an emergency, you may need an electric shock to the heart. If there’s a good chance you’ll have VT again, the best way to prevent fatal problems is with an implantable cardioverter-defibrillator (ICD). 

How serious is ventricular tachycardia?

It can be harmless if it only lasts a few seconds. But V-tach can be life-threatening if you have an episode longer than 30 seconds and it leads to ventricular fibrillation, which prevents your heart from pumping blood to the rest of your body. 

What to do if a patient is in V-tach?

Go to the emergency room if you or a loved one have ventricular fibrillation for longer than 30 seconds. You’ll need treatment right away with medication or a device that sends electrical shocks to your heart. The goal is to quickly restore your regular heart rate. 

Is ventricular tachycardia worse than AFib?

Both can be serious, but you’re more likely to die from an episode of ventricular tachycardia than atrial fibrillation. But people who have Afib may be more likely to develop VT later on. Ask your doctor if that could happen to you.