Ventricular Tachycardia: Management

Key points

• Peri-arrest broad complex tachycardia is assumed ventricular in origin (ERC advice).
• Adverse signs (SBP < 90 mmHg, chest pain, heart failure, syncope) → immediate cardioversion.
• Without adverse signs: antiarrhythmics — amiodarone (ideally central line) · lidocaine (caution in severe LV impairment) · procainamide.
• Verapamil should NOT be used in VT.
• If drug therapy fails: electrophysiological study · ICD (especially with significantly impaired LV function).

Decision points in this pathway

• Adverse signs? (SBP < 90 mmHg · chest pain · heart failure · syncope)
• Drugs fail?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.