Ventrikel Takhikardi

PART I
preliminary
A. Background
The heart is a hollow organ, muscular, which is located in the middle of the thorax,
and occupies the cavity between the lung and the diaphragm. It weighs about 300 grams
(10.6 oz) despite its weight and size is influenced by age, sex, weight, weight training,
physical activity, and cardiovascular disease. Working heart pumping run by the rhythmic
contraction and relaxation of the muscle wall(1, 2).
Ventricular tachycardia / ventricular tachycardia (VT) is that there are three or more
premature ventricular contraction or ventricular extrasystole at a rate more than 120 times
per minute. Focus can be derived from ventricular tachycardia (left or right) or as a result of
the process reeentry on one part of the branch bundle (bundle branch reentry VT)(1, 3).
Ventricular tachycardia is a heart rhythm disorder characterized by irregular heartbeats
but fast. Adult heart beating normally between 60 and 100 times per minute in a resting
state. In ventricular tachycardia, the heart beats more than 100 times per minute it is due to
the disruption of normal electrical impulses that control heart rate. Ventricular tachycardia
or ventricular tachycardia is a condition when the heart chambers (ventricles) beats very fast,
which is more than 100 times per minute, with a minimum of 3 consecutive abnormal beats.
This condition is caused by electrical disturbances in the heart, usually occurs in heart
defects, such as cardiomyopathy and coronary heart disease(1, 4).
ECG recording surface of VT generally provides ECG with the characteristics of a
wide QRS complex (> 0:12 seconds). But not all of tachycardia with a wide QRS complex is
VT for supraventricular tachycardia (SVT) by conduction aberan or by conduction through
an additional pathway (accesory pathway) will also provide an overview of tachycardia with
a wide QRS complex. Therefore, the introduction of VT becomes important in a state of
urgency because the drugs can be harmful to SVT in patients with VT. VT introduction
should also include identification of the etiology, resources, focus, therapy, and prognosis.
Idiopathic VT, for example, may be treated as definitive by catheter ablation, a very rare
cause of sudden death and has a good prognosis(1, 3).
Tachycardia with wide QRS complexes are EKG that quite often we find. Basically,
there are 3 heart rhythm abnormalities that can produce ECG tachycardia with wide QRS
complexes, namely: ventricular tachycardia (VT) is the most common (80%), tachycardia,
supraventricular (SVT) with aberansi (15-20%), and Atrioventriculare Reentrant Tacycardia
(AVRT) with conduction antidromik (1-6%). Proper diagnosis to differentiate SVT with
aberansi and VT is very important, because both have different pathophysiology and
mechanisms. This causes the therapy needs to be given is different, and fault of therapy can
result in potentially fatal. Because the ECG remains the primary modality for diagnosing
tachycardia with wide QRS complexes, then many algorithms are proposed to help establish
the diagnosis. The most commonly used algorithms are algorithms Brugada has long existed
and has a specificity and sensitivity were quite good(3, 5).
In 2007 Vereckei et al. create new algorithms are used to distinguish SVTdengan
aberansi and VT. In 2008, Vereckei back to renew algorithmically by using only one aVR
lead is only to distinguish between VT and SVT with aberansi where the algorithm is based
on the principle difference vector direction and speed of electrical impulses. In addition
there is also a new method known as Brugada ultrasimple criterion proposed by Brugada in
2010 where not much research discusses about the accuracy of these criteria. The most
commonly used algorithms are algorithms Brugada has long existed and has a specificity
and sensitivity were quite good(5).
In 2007 Vereckei et al. create new algorithms are used to distinguish SVTdengan
aberansi and VT. In 2008, Vereckei back to renew algorithmically by using only one aVR
lead is only to distinguish between VT and SVT with aberansi where the algorithm is based
on the principle difference vector direction and speed of electrical impulses. In addition
there is also a new method known as Brugada ultrasimple criterion proposed by Brugada in
2010 where not much research discusses about the accuracy of these criteria. The most
commonly used algorithms are algorithms Brugada has long existed and has a specificity
and sensitivity were quite good. In 2007 Vereckei et al. create new algorithms are used to
distinguish SVTdengan aberansi and VT. In 2008, Vereckei back to renew algorithmically
by using only one aVR lead is only to distinguish between VT and SVT with aberansi where
the algorithm is based on the principle difference vector direction and speed of electrical
impulses. In addition there is also a new method known as Brugada ultrasimple criterion
proposed by Brugada in 2010 where not much research discusses about the accuracy of these
criteria(1).
Ninety percent of ventricular arrhythmias in STEMI occurs within the first 48 hours,
while at 60% NSTEMI ventricular arrhythmias occurred after 48 hours. In the early period
of post myocardial infarction, the incidence of nonsustained VT reaches 13%, 3% sustained
VT and VF 3%. In two studies (GUSTO IIB and III GUTSO) sustained ventricular
arrhythmias (sustained) occurred in 6% of patients with acute coronary syndromes (ACS).
The incidence will be considerably increased in patients - patients who have congenital
abnormalities, such as the syndrome of long-QT (LQTS), syndrome short-QT, syndrome
Wolff-Parkinson-White syndrome, Brugada, arrhythmogenic right ventricular
cardiomyopathy, hypertrophic cardiomyopathy, catecholaminergic polymorphic ventricular
tachycardia ( CPVT) as well as other genetic variants(3).
B. Formulation of the problem
How the definition, classification, etiology, clinical signs and symptoms, pathophysiology
and management of theVentricular tachycardia (VT) ?
C. Aim
1. To find the definition of ventricular tachycardia (VT)
2. To determine the classification of ventricular tachycardia (VT)
3. To determine the etiology of ventricular tachycardia (VT)
4. To know the signs and symptoms of ventricular tachycardia (VT)
5. To determine the pathophysiology of ventricular tachycardia (VT)
6. To know the management of ventricular tachycardia (VT)
1. Maharani E, Yuniadi Y. Outflow Tract Ventricle Tachycardia Ablation. Indonesian Journal of
Cardiology. 2012:28-33.
2. Yuniadi Y, Achmad C, Munawar M. Ablasi Konvensional Kepak Atrium Atipikal. Indonesian
Journal of Cardiology. 2007:220-3.
3. Yuniadi Y. Takikardia Qrs Lebar: Apa Mekanismenya? Indonesian Journal of Cardiology.
2016:61-2.
4. Wangko LC, Jim EL. PEMETAAN DAN ABLASI PADA TAKIKARDIA VENTRIKEL
AKIBAT PARUT. JURNAL BIOMEDIK. 2015;7(3).
5. Hanafy DA. How to Choose Between Rate and Rhythm Control Strategy. Indonesian Journal of
Cardiology. 2010:187-95.

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PART I

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