Ventricular Tachycardia

  1. General information
    1. A run of three or more consecutive PVCs; occurs from repetitive firing of an ectopic focus in the ventricles
    2. Caused by acute MI, CAD, digitalis intoxication, hypokalemia
  2. Assessment findings
    1. Rate
      1. Atrial: 60-100 beats/minute
      2. Ventricular: 110-250 beats/minute
    2. Rhythm: atrial (regular), ventricular (occasionally irregular)
    3. P wave: often lost in QRS complex
    4. P-R interval: usually not measurable
    5. QRS complex: greater than 0.12 seconds, wide
  3. Treatment
    1. IV push of lidocaine (50-100 mg), then IV drip of lidocaine 1-4 mg/minute
    2. Procainamide via IV infusion of 2-6 mg/minute
    3. Direct-current cardioversion
    4. Bretylium, propranolol (Inderal)

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