Expert Cardiology Part 2

Question 14/28
What medication can frequently terminate ventricular tachycardia originating from the right ventricular outflow tract? From the left posterior fascicle?
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Question 14/28
What medication can frequently terminate ventricular tachycardia originating from the right ventricular outflow tract? From the left posterior fascicle?

Adenosine sensitive ventricular tachycardia occurs in structurally normal hearts and arises from the right ventricular outflow tract (pulmonary infundibulum). This gives it a left bundle branch block morphology on the 12-lead ECG.

Adenosine can terminate this rhythm as the name implies, however ablation is the treatment of choice and success rates are high. Beta-blocker therapy is moderately effective to treat this rhythm. Unlike other forms of ventricular tachycardia, adenosine sensitive ventricular tachycardia is usually hemodynamically stable.

Verapamil sensitive ventricular tachycardia is a form of idiopathic ventricular tachycardia that occurs with a structurally normal heart arising from the left posterior fascicle. This manifests as a right bundle branch block pattern on the ECG with a left axis deviation. Verapamil can acutely terminate the rhythm as the name implies. Ablation is the therapy of choice.

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