Long-term management of sustained ventricular tachycardia without structural heart disease

Patients with sustained ventricular tachycardia should be thoroughly evaluated for the presence of structural heart disease, in particular the presence of coronary artery disease and left ventricular dysfunction.

Patients with sustained ventricular tachycardia and no structural heart disease generally have a good prognosis, and an implantable cardioverter defibrillator (ICD) is not usually required. However, referral to a cardiologist is required for further investigation and management.

Drugs such as beta blockers (eg atenolol, metoprolol tartrate), flecainide or verapamil may be used under specialist supervision for recurrent sustained ventricular tachycardia in patients without structural heart disease.

Catheter ablation can also be considered in patients with recurrent sustained ventricular tachycardia.