Sustained monomorphic ventricular tachycardia associated with structural heart disease: classification, assessment, and initial treatment

Abstract

Sustained monomorphic ventricular tachycardia occurs in patients with structural heart disease and may lead to syncope, haemodynamic collapse, or sudden death. The diagnosis is established by the electrocardiogram, with cardiac imaging used to determine the underlying substrate. Initial management requires a combination of electrical cardioversion and antiarrhythmic drugs, mainly amiodarone and beta blockers. Nonetheless, implantable cardioverter defibrillators provide the most substantial reduction in sudden death, with catheter ablation becoming an increasingly favoured strategy to minimize shocks and possibly lower mortality from ventricular arrhythmias in this population.