[Clinical spectrum of ventricular tachycardias]

Substantial information has been accumulated concerning the mechanisms, electrocardiographic patterns and electrophysiologic characteristics of various ventricular tachycardias. As a result, several distinct clinical entities of ventricular tachycardia can be identified, each of them with different manifestation, prognostic importance and management strategies. Among monomorphic tachycardias, the sustained ventricular tachycardia after myocardial infarction is the most frequent form, accounting for more than 70% of all ventricular tachycardias. Monomorphic ventricular tachycardias are less frequently associated with dilated or hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia and other diseases. Distinct entity that should not go unrecognised is the bundle branch re-entry and/or interfascicular re-entry. Finally, there is a heterogeneous groups of idiopathic ventricular tachycardias occurring in patients without hay structural heart disease. Polymorphic ventricular tachycardias are often associated with either congenital or acquired QT interval prolongation, the so called torsade de pointes arrhythmias. In addition, some polymorphic ventricular tachycardias without QT interval prolongation may be triggered by ischaemia and/or can occur in patients with previous myocardial infarction. The review describes all the most important varieties of monomorphic and polymorphic ventricular tachycardias together with the treatment options.