Introduction: Ventricular Arrhythmias

Ventricular Tachycardia

Monomorphic ventricular tachycardia (MVT) and polymorphic ventricular tachycardia (VT) are abnormal heart rhythms that demand attention. MVT is characterized by fast, regular ventricular contractions originating from one ventricular focus, and it poses significant risks such as hemodynamic instability, syncope, sudden cardiac death, or progression to ventricular fibrillation. It affects approximately 100,000 people annually in the U.S. and often signals underlying heart conditions like myocardial infarction, cardiomyopathy, arrhythmogenic right ventricular dysplasia, or long QT syndrome. Clinical pharmacists play a crucial role in identifying MVT on ECG, aiding in antiarrhythmic medication selection, monitoring for efficacy and side effects, and educating patients for improved outcomes. In contrast, polymorphic VT, although less common than MVT, is a highly unstable and life-threatening heart rhythm disorder characterized by irregular, rapid ventricular beats, commonly associated with sudden cardiac death, particularly exemplified by torsades de pointes. Polymorphic VT arises in the presence of underlying heart diseases, electrolyte imbalances, drug toxicity, or channelopathies affecting myocardial repolarization. Clinical pharmacists are instrumental in recognizing polymorphic VT on ECG, comprehending its mechanisms, and facilitating appropriate pharmacological interventions to prevent progression to ventricular fibrillation and cardiac arrest. Prompt recognition and intervention are pivotal in both MVT and polymorphic VT cases to ensure better patient outcomes.