Non sustained Ventricular Tachycardia (NSVT)

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  • Published on:  2/25/2017
  • This video is about Non sustained Ventricular Tachycardia (NSVT). If you would like to contact me you can do so via my website www.yorkcardiology.co.uk or my email/facebook -yorkcardiology@gmail.com
    What is ventricular tachycardia.

    Ventricular tachycardia is a condition where the electrical impulses instead of being produced by the pacemaker of the heart are produced by the ventricles and therefore each beat of the heart does not pump out as much blood as it should and secondly there is a tendancy for the heart to go very fast and therefore the demand goes up and supply goes down together and in some patients after sometime this can lead the heart suffocating because it is not getting enough blood and this can then lead to ventricular fibrillation and death and this is why ventricular tachycardia is painted to be such a dangerous heart rhythm disturbance. It is very important to understand that for this to happen the ventricular tachycardia has to be sustained i.e it has to go on for 30 seconds or more,

    Now there is also a condition called non sustained ventricular tachycardia which is far more common than ventricular tachycardia. Non sustained ventricular tachycardia by definition is not sustained!i.e it lasts less than 30 seconds.

    The definition of non sustained ventricular tachycardia is 3 or more ventricular ectopics in a row at a rate of more than 120 beats per minute. So that could mean as few as 3 beats or upto 30 or 40 continuous beats. Even though they would be both classified as non sustained VT, a patient with 3 beats of NSVT is clearly not as worrying to me as someone with 30 continuous beats of NSVT

    We see ectopics on holters and we occasionally see 3 ectopics in a row and therefore the holter is reported as showing non sustained VT and this causes a great deal of anxiety for the patient because they assume that because it carries the words Ventricular tachycardia in it, people often think it is as dangerous as ventricular tachycardia.

    So let me explain a few things:

    1) It is almost impossible to know just from how they feel as to whether they are ventricular or atrial and definitely impossible to say that they definitely represent NSVT. Non sustained VT is an ecg based diagnosis not a clinical diagnosis. It may be completely asymptomatic.

    2) NSVT by definition is not sustained and therefore not dangerous. Sustained VT will feel like this bang bang bang……

    3) Up to 3% of normal completely healthy people have NSVT.

    4) NSVT is seen in normal hearts but is seen more frequently seen in diseased hearts and therefore if someone is found to have non sustained VT all it means is that the doctor needs to more tests to work out whether the heart is diseased or not. If the heart is diseased, it tells me that the heart is irritable and in that setting I would be concerned that if the patient could potentially in the future develop sustained VT and the heart would not be able to cope with the reduced supply increased demand as it is already compromised. If the heart is not diseased I would feel extremely reassured.
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