Right Ventricular Outflow Tract Tachycardia - Causes, Symptoms, and Treatment

Introduction:

The human heart has four chambers, of which two are the atrium and rest two are the ventricles. The upper one is the left and right atrium. The lower are the left and right ventricles. Right ventricular outflow tachycardia is a heart condition in which the patient experiences an abnormality in a heartbeat. The heartbeat can be rapid or repetitive. The heart condition falls under the category of idiopathic ventricular tachycardia, in which the condition lacks etiology. It occurs in individuals with a typical structure of the heart. But, clinically, the patient may experience dizziness, chest discomfort, and palpitations. The life-threatening condition needs accurate diagnosis and appropriate management. Electrocardiography differentiates right ventricular outflow tachycardia from other heart conditions. The introduction highlights the right ventricular outflow tachycardia, its causes, symptoms, diagnosis, and management considerations.

What Is Ventricular Tachycardia?

Ventricular tachycardia is a heart disorder in which an individual experiences consecutive heartbeats. These start from the lower heart chambers called ventricles. This can disrupt the normal heart rhythm, leading to faster contraction of the ventricles. The abnormal heart rhythm affects the heart's pumping system, leading to decreased oxygen and blood supply. In severe cases, ventricular tachycardia may lead to cardiac arrest.

What Is Right Ventricular Outflow Tachycardia?

Right ventricular outflow tachycardia is a type of ventricular tachycardia. The condition starts from the right ventricle outflow tract. This tract is present between the pulmonary valve and the proximal pulmonary artery. Abnormal activity in the right outflow tract, such as abnormal electrical activity, can cause irregular heartbeats. The heartbeat is faster than expected. The condition is non-cancerous and non-spreading but impacts the patient's life, which can be managed with treatment.

What Are the Causes of Right Ventricular Outflow Tachycardia?

The right ventricular outflow tachycardia comes under idiopathic ventricular tachycardia, lacking the exact cause. But, several factors can lead to the development of the heart condition. The causes of right ventricular outflow tachycardia are as follows:

• Idiopathic Cause: In many cases, the condition occurs without proper cause. The cause of the heart condition is not identified, so it is called idiopathic. The patient's heart structure is normal, but the electrical pathways are abnormal. This can lead to the formation of idiopathic right ventricular outflow tachycardia.

• Structural Heart Disease: The abnormality in the heart's structure can cause the condition's development. The structural abnormalities include right ventricular outflow tract anomalies, congenital heart defects, and right ventricular hypertrophy. These can form a substrate for the development of abnormal electrical pathways.

• Genetic Factors: Gene variation in the ion channels of the heart and other electrical components can cause abnormal heart rhythm, which plays a role in the development of the condition.

• Electrolyte Imbalance: The electrolyte level imbalance, like magnesium, sodium, calcium, and potassium, can affect the heart's electrical activity, leading to abnormal heart rhythms.

• Adrenergic Stimulation: During any physical activity or stress, the activity of the sympathetic nervous system increases, causing episodes of right ventricular outflow tract tachycardia.

• Inflammation: An inflamed heart muscle can affect regular electrical activity and contribute to abnormal heart rhythms.

• Cardiac Conditions: The condition can occur in people with cardiac conditions such as coronary artery disease, ischemic heart disease, and heart attacks.

• Medications: Certain medications, such as antiarrhythmic and stimulants, can trigger the condition.

What Are the Signs and Symptoms of Right Ventricular Outflow Tachycardia?

The signs and symptoms of right ventricular outflow tachycardia are as follows:

• Palpitations: The patient may experience the most common symptom. The patient may feel a strong, rapid, and irregular heartbeat.

• Dizziness: The patient may feel dizziness or lightheadedness when suddenly the heart rate increases.

• Shortness of Breath: During an episode of right ventricular tachycardia, the patient may have difficulty breathing.

• Fatigue: During an exercise or physical activity, when the heart works harder than normal, there can be unexplained tiredness.

• Syncope: When there is a decrease in the blood pressure rate, or the heart rate becomes rapid, the patient faints.

• Chest Discomfort: There can be pain in the chest, tightness, or a sensation of pressure in the chest area.

• Rapid Pulse: The heart rate can be more than expected.

• Prolonged Episodes: The patient may face tachycardia episodes, lasting for minutes to hours.

• Irregular Heartbeat: There can be an irregular heartbeat.

• Anxiety: The patient may experience anxiety episodes that may trigger feelings of panic.

• Exercise Intolerance: The patient with the condition may be unable to engage in physical activity. The reason behind exercise intolerance is rapid heart rate.

How Is Right Ventricular Outflow Tachycardia Diagnosed?

Right ventricular outflow tachycardia can be diagnosed in the following ways:

• Clinical Evaluation: The healthcare provider may assess the clinical symptoms related to the condition. They also inquire about the heartbeat, palpitations, fainting, and dizziness episodes.

• Physical Examination: The healthcare provider may physically examine the abnormal heart sound. The doctor also checks the blood pressure, pulse, and heart rate.

• Electrocardiogram (ECG): The device finds the tachycardia patterns and the heartrate abnormalities associated with the condition.

• Echocardiogram: The device provides images of heart structure abnormalities that may cause or contribute to right ventricular outflow tachycardia.

• Cardiac Magnetic Resonance Imaging (MRI): The tests will identify the condition's cause, such as electrolyte imbalance and thyroid dysfunction.

How Is Right Ventricular Outflow Tachycardia Treated?

The treatment of right ventricular outflow tachycardia is as follows:

• Lifestyle Modifications: The patient may be advised to follow lifestyle changes such as managing stress, avoiding caffeine intake, and avoiding alcohol intake, which may help control tachycardia episodes.

• Vagal Maneuvers: Techniques such as carotid sinus massage and Valsalva maneuver can stimulate the vagus nerve. This will help in slowing down the heart rate during episodes of tachycardia.

• Medications: The doctor may prescribe antiarrhythmic medications such as calcium channel blockers and beta-blockers. These drugs help in controlling heart rate and heart rhythm. The other medications given by the doctor are Flecainide or Propafenone.

• Radiofrequency Ablation: The healthcare provider uses a procedure in which the catheter is placed to destroy the abnormal tissue. This will help in reducing tachycardia episodes.

• Surgery: The doctor may advise surgical procedures to eliminate the source of tachycardia. The surgery is prescribed when the other approaches are ineffective.

Conclusion:

In conclusion, right ventricular outflow tract tachycardia is a heart condition that can lead to palpitations, fainting, shortness of breath, and dizziness. A combination of clinical evaluation, electrocardiogram, and echocardiogram can diagnose the condition. The doctor may advise the patient to follow lifestyle changes, surgical interventions, and catheter ablation. The management helps in managing symptoms and preventing life-threatening complications.