Pulseless ventricular tachycardia is a life-threatening cardiac emergency that results in death without immediate treatment. It is a temporary state where the heart’s ventricles pump rapidly but ineffectively, leading to a lack of oxygenated blood circulation. Treatment involves manual chest compressions, intubation, oxygen, and electric shock.
Pulseless ventricular tachycardia is a life-threatening cardiac emergency that ends in death without prompt and immediate treatment. The term tachycardia refers to a rapid heartbeat, usually understood to be greater than 100 beats per minute. Ventricular refers to a rapid heart rate that is electrically initiated by the heart’s lower chambers – the ventricles – as opposed to the usual control center in the atria, the bundle of His. Pulseless refers to the fact that the ventricles pump so rapidly and out of service with the atria that the normal volume of blood ejected with each heartbeat — a pulse — is absent. Hence, this condition is a temporary state in which the large ventricles of the heart are pumping very rapidly but completely ineffective.
As noted above, pulseless ventricular tachycardia is a temporary heart condition. It is considered temporary because it is not consistent with life. Despite the fact that the heart moves, it does not beat and therefore fails to circulate oxygenated blood to the body’s tissues and organs, including the heart. Hypoxia or low oxygen concentrations cause cell and tissue death within minutes. Pulseless ventricular tachycardia turns into ventricular fibrillation, in which the heart simply quivers — coincidentally known as a “v fib” — which quickly turns into asystole, the straight line drawn on an ECG machine familiar to fans of TV dramas.
Many medical conditions can predispose someone to developing pulseless ventricular tachycardia. Previous heart disease with tissue death along the electrical conduction pathways of the heart may be a factor. Experts believe that a sustained event of pulseless ventricular tachycardia was often preceded by short, self-limited strokes — six beats or fewer — on one or more occasions. Other conditions that may facilitate the development of this condition include hypokalemia or hypoxia. Hypokalemia is the medical term for low serum potassium levels, which tends to make the ventricles irritable; hypoxia, on the other hand, describes a situation of oxygen deficiency and this condition can impair higher levels of cardiac electrical functioning.
Treatment of pulseless ventricular tachycardia is an emergency procedure commonly referred to as code. Manual chest compressions are administered to simulate functional heartbeats and blood volume circulation. Intubation or the placement of a breathing tube is performed, and oxygen is given with a manual bag valve mask or ventilator to prevent tissue death. An electric shock is delivered by an automated electric defibrillator (AED) or manual defibrillator in an attempt to stop the dangerous ventricular rhythm and allow the heart to return to a functional rhythm. If the code was successful, the patient is treated in an intensive care unit (ICU) or cardiac care unit (CCU).
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