What Is Pulseless Ventricular Tachycardia?

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  • Written By: Susan Abe
  • Edited By: Jessica Seminara
  • Last Modified Date: 10 May 2020
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Pulseless ventricular tachycardia is a life-threatening cardiac emergency that ends in death without prompt and immediate treatment. The term tachycardia refers to a rapid heart rate, routinely understood as greater than 100 beats per minute. Ventricular refers to a rapid heart rate electrically initiated by the heart's lower chambers — the ventricles — as opposed to the usual control center in the atria, the Bundle of His. Pulseless refers to the fact that the ventricles are pumping so quickly and out of order with the atria that the usual volume of blood ejected with each heartbeat — a pulse — is absent. Thus, this condition is a temporary state wherein the heart's large ventricles are pumping very rapidly but completely ineffectually.

As noted above, pulseless ventricular tachycardia is a temporary cardiac condition. It is considered temporary because it is inconsistent with life. Despite the fact that the heart is moving, it is not beating and thus, is failing to circulate oxygenated blood to the body tissues and organs, including the heart. Hypoxia or low oxygen concentrations result in cellular and tissue death within minutes. Pulseless ventricular tachycardia devolves into ventricular fibrillation, wherein the heart simply quivers — casually known as "v fib" — which quickly turns to asystole, the straight line traced on an EKG machine known to fans of television medical dramas.

Many medical conditions can predispose someone to the development of pulseless ventricular tachycardia. Previous heart disease with tissue death along the heart's electrical conduction pathways can be a major factor. It is thought by experts that a sustained event of pulseless ventricular tachycardia has often been preceded by short, self-limited runs — six beats or less — on one or more occasions. Other conditions that can facilitate the development of this condition include hypokalemia or hypoxia. Hypokalemia is the medical term for low serum levels of potassium, which tends to make the ventricles irritable; hypoxia, on the other hand, describes a situation of low oxygen and this condition may damage higher levels of cardiac electrical functioning.

Treatment of pulseless ventricular tachycardia is an emergency procedure commonly referred to as a code. Manual chest compressions are administered in order to simulate functional heartbeats and blood volume circulation. Intubation, or the placement of a breathing tube, is performed and oxygen is administered with a manual bag valve mask or ventilator to help avoid tissue death. An electrical shock is administered by an automated electrical defibrillator (AED) or a manual defibrillator in an attempt to interrupt the dangerous ventricular rhythm and allow a functional heart rhythm to resume. If the code has been successful, the patient is treated in an intensive care unit (ICU) or cardiac care unit (CCU).

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Post 2

My mom worked in a doctor's office, and a hospital before that, and she always watched all the medical shows on TV. Some things she explained to us, but like Grivusangel, it's nice to get a detailed explanation of a term you hear a lot on those shows.

Several years ago, we had a customer collapse in the office, and of course, we called the EMTs. They had to use a defibrillator because he went into v-fib. He made it to the hospital, thank goodness, but it was sure enough scary, hoping the EMTs would be able to shock his heart back into rhythm.

Post 1

This actually explained some things for me. I always thought "coding" referred to the heart actually stopping, not racing so fast there is no pulse. I also knew v-fib was very serious, but not exactly what it was. So, I learned something today!

The next time I see a medical show, if someone has heart problems, then I'll have a much better idea about what is going on with the patient. It really does help me to know a little bit about what's happening with the patient so I can really get a feel for the urgency of the situation.

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