Sustained ventricular tachycardia (VT) in coronary artery disease (CAD): A study from tertiary care center in north India

Background: Ventricular Tachycardia (VT) constitutes an important manifestation of coronary artery disease (CAD). VT can occur in the immediate acute myocardial infarction (MI) period, further complicating the management. VT also occurs after long duration of acute coronary syndrome (ACS) in the healed MI. Aim: The aim of our study was to evaluate the epidemiology, clinical presentation, hemodynamic status, treatment received and finally the outcome of CAD patients manifesting as sustained VT. Materials and methods: This prospective study was conducted at Sher I Kashmir Institute of Medical Sciences (SKIMS), a tertiary care center in Srinagar, Jammu and Kashmir, India, between August 2013 to May 2016. All the cases of definite sustained VT already admitted in the hospital or presenting in the emergency department including those who developed VT during the course of acute MI were evaluated. Results: In our study, a total of 35 patients of CAD manifesting as sustained VT were observed. Majority of these patients were males. The most common presenting symptom was chest pain seen in a total of 14 patients. A total of 23 patients (66%) were hemodynamically stable at the time of VT. A decreased Left Ventricular Ejection Fraction (LVEF <50%) was seen in 18 patients (51%). Monomorphic VT was seen in a total of 28 patients (80%) and the rest of 7 patients showed polymorphic VT. Mortality was seen in 8 patients (23%). Conclusion: Polymorphic pattern of sustained VT, hemodynamic instability at the time of VT and a decreased LVEF are associated with increased mortality in patients of CAD manifesting as VT.