Types of Ventricular Arrhythmias

At NYU Langone’s Heart Rhythm Center, our specialists are highly experienced and trained to manage all types of ventricular arrhythmias. These disorders cause abnormally rapid and, in some cases, potentially life-threatening heart rhythms.

When your heart is at rest, it beats at a steady rhythm of 60 to 100 beats per minute. Ventricular arrhythmias cause problems with the heart’s electrical system, leading it to beat too fast and, sometimes, chaotically.

When an arrhythmia occurs in the ventricles, the heart has a hard time pumping enough blood to the body. Left untreated, some types of ventricular arrhythmias may lead to a loss of consciousness and sudden cardiac arrest or death.

People with ventricular arrhythmias frequently have a history of heart disease, including a prior heart attack, a congenital heart defect, an inherited cardiomyopathy, or an electrolyte imbalance that can be caused by dehydration or extreme exercise or dieting. Certain conditions can also contribute to ventricular arrhythmia, including hyperthyroidism, sarcoidosis, and diabetes. Use of recreational drugs or steroids also puts a person at risk.

There are several types of ventricular arrhythmias, including premature ventricular contractions, ventricular tachycardia, and ventricular fibrillation. Treatment can include lifestyle changes, medications, implantable cardioverter defibrillators, and catheter ablation.

Premature Ventricular Contractions

Premature ventricular contractions, also known as premature beats, are extra, abnormal heartbeats that originate in the ventricles. It may feel as if your heart has “skipped a beat.” This feeling is caused by a premature discharge of electrical impulses to the heart’s ventricles that causes an extra beat to occur before a normal heartbeat would.

After you experience a premature heartbeat, blood begins to fill the ventricle. The additional amount of blood in the heart gives the next beat extra force, making it feel stronger. Symptoms include heart palpitations that feel like a fluttering or flip-flopping in the chest.

This arrhythmia is not dangerous in healthy people because it usually has little impact on the heart. But in people with heart problems, such as a heart valve disease, or those who have had a heart attack, it can trigger more dangerous arrhythmias. These can include ventricular tachycardia or ventricular fibrillation.

Premature ventricular contractions can be caused by alcohol or caffeine intake, emotional or physical stress, or cold or allergy medications that contain pseudoephedrine, which stimulates the heart.

Ventricular Tachycardia

Ventricular tachycardia (VT) is a rapid heart rhythm—more than 100 beats per minute—that begins in the lower chambers of the heart. This condition prevents the heart’s chambers from filling adequately with blood, reducing the amount that is pumped to the body. VT requires immediate medical attention.

This condition is commonly caused by a previous heart attack, which can create scar tissue that interferes with the heart’s electrical signals. It can also occur in people with cardiomyopathy, a condition in which the heart enlarges, thickens, or stiffens, reducing its ability to pump blood to the body, or idiopathic ventricular tachycardia, which is an electrical disorder that can occur in patients who do not have heart disease. The use of recreational drugs such as cocaine can also trigger VT.

Symptoms vary and can include heart palpitations, chest pain, lightheadedness or dizziness, shortness of breath, or fainting. Some people notice no symptoms. Some types of VT require an implantable cardioverter defibrillator, which monitors your heart for abnormal rhythms and delivers an electrical shock or shocks to bring your heart back into a normal rhythm.

Ventricular Fibrillation

Ventricular fibrillation is a life-threatening arrhythmia. Out-of-control electrical signals cause the ventricles to twitch and quiver. Blood, which requires steady, strong pulses to effectively move out of the heart, becomes trapped. When blood does not circulate, it cannot deliver oxygen to the body. Left untreated, ventricular fibrillation can lead to sudden cardiac arrest and, in severe cases, death.

Heart attack is the most common cause of ventricular arrhythmia, but it can also occur during heart surgery or as a result of cardiomyopathy or a genetic heart rhythm disorder, such as long QT syndrome or Brugada syndrome. Ventricular fibrillation can also be caused by recreational drug use, including cocaine.

Symptoms include heart palpitations, chest pain, lightheadedness or dizziness, nausea, shortness of breath, and loss of consciousness. Immediate treatment, using either an automated external defibrillator found in public places or a defibrillator in an emergency department, is required.