Ventricular tachycardia – treatment

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  • Wide complex tachycardia is almost always ventricular tachycardia
  • If there is evidence of hemodynamic compromise, DC cardioversion should be done immediately at 100J then 200,300,360
  • If there is no evidence of hemodynamic compromise- amiodarone and lidocaine are favoerd over procainamide ( exacerbates CHF)
  • Chronic management: besides medications ( class I anti-arrhythmics, beta-blockers), ICD implantation, and catheter-based ablation
  • Additional treatment: magnesium sulfate for torsade de point, correct hypokalemia, and discontinue drugs causing QT interval prolongation
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