Tachycardia is a broad term for a variety of rapid cardiac arrhythmias.1,2 It is commonly associated with underlying cardiac abnormalities.1,2 If left untreated, in serious cases, this can lead to heart failure or cardiac arrest.3,4
SUMMARY OF GUIDELINES
2022 European Society of Cardiology (ESC) Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death.5
Patients with incidental NSVT (≥3 consecutive ventricular beats lasting <30 seconds) should undergo risk stratification and diagnostic assessment to determine whether the arrhythmia is idiopathic or related to underlying cardiac pathology.5
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The majority of patients presenting with SMVT (continuous VT for at least 30 seconds or requiring intervention for termination) have underlying structural heart disease. Diagnostic assessment is important to determine the underlying etiology and identify patients with idiopathic VT.5
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Acute management of regular wide QRS complex tachycardia requires assessment of hemodynamic status and underlying etiology to guide appropriate treatment, including cardioversion when indicated.5
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After excluding structural heart disease, management of idiopathic PVCs/VT is guided by symptoms, PVC burden, and PVC/VT origin, with catheter ablation recommended as first-line therapy for right ventricular outflow tract (RVOT) and fascicular PVCs/VT.5
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ALS, advanced life support; ARVC, arrhythmogenic right ventricular cardiomyopathy; CAD, coronary artery disease; CAG, coronary angiography; CCB, calcium channel blocker; CMR, cardiac magnetic resonance; ECG, electrocardiogram; EP, electrophysiological; LV, left ventricular; LVEF, left ventricular ejection fraction; N, No; NSVT, non-sustained ventricular tachycardia; (NT-)proBNP, N-terminal pro-B-type natriuretic peptide; PET-CT, positron emission tomography and computed tomography; PVC, premature ventricular complex; RV, right ventricular; RVOT, right ventricular outflow tract; SCD, sudden cardiac death; SHD, structural heart disease; SMVT, sustained monomorphic ventricular tachycardia; SVT, supraventricular tachycardia; T4, thyroxine; TSH, thyroid stimulating hormone; VA, ventricular arrhythmia; VT, ventricular tachycardia; Y, Yes.
- NHS. Heart rhythm problems (arrhythmia). Available at: www.nhs.uk/conditions/arrhythmia/. Accessed June 11, 2026.
- American Heart Association. Tachycardia: Fast heart rate. Available at: https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate. Accessed June 11, 2026.
- Mayo Clinic. Supraventricular tachycardia – Symptoms and causes. Available at: www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/symptomscauses/syc-20355243. Accessed June 11, 2026.
- Mayo Clinic. Ventricular tachycardia – Symptoms and causes. Available at: www.mayoclinic.org/diseases-conditions/ventricular-tachycardia/symptoms-causes/syc-20355138. Accessed June 11, 2026.
- Zeppenfeld K, Tfelt-Hansen J, de Riva M, et al. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J. 2022;43(40):3997–4126. doi: 10.1093/eurheartj/ehac262.