How is a-fib and VF different from VT?

[Christine0687]

I was diagonsed with VT but I am wondering if my diagnosis is correct. Can anyone tell me what the difference is? I was told that it is rare that VT can cause sudden cardiac death but what about a-fib and VF? Thanks!

[nervouslady]

I question them for a very long time.  And have done a lot of reading.   I think you have to be your own advocate and push people.  I'm pretty laid back when it comes to other stuff (wait, not really, but I try) but when it comes to things like this I pester!  LOL!   I was just about to start med school when I had my stroke 10 years ago so I know the basic basic stuff, enough to ask questions, but not enough to understand all of this.  It's so complicated!  Nothing makes more more angry than a dinky doctor who doesn't feel he or she has to explain something to me.  Some are so wonderful and helpful and some think they are above explaining (or like you said, being questioned).  

VT can turn into VF - but that is very rare if you are only experiencing non sustained VT and your heart is structurally sound.  I think the chances of VF happening in someone with NSVT and a strong heart is just the same as the average population without NSVT.   Because of my recent abnormal echo findings, I am not in that category, unfortunately, so I have to lay low until we figure more out.  I don't know if I'm at risk for VF or sustained VT but I'm guessing I might be or they wouldn't have told me not to exercise.  Sustained VT has a higher incidence of turning into VF.  I don't know percentages or odds on that, though.

[Christine0687]

Were you ever told that VT can convert to VF? OR is that rare???

[Christine0687]

You are becoming quite the expert with all of this stuff going on. Thank you. Because you know when you ask doctors how they know or what would be the diff, they get an attitude like you are questioning them. I am really not questioning them, I just need to know how they know it is one thing or the other for my own sanity!

[nervouslady]

Oh, and as for VF - you are basically dying when VF is going on.  You know how, on TV shows, when someone is dying, their heart monitor shows a normal rhythm, beep...beep...beep..beep...then all of a sudden it goes beebeebeebeebeebeeebeee....beeeeeeeeeeeeeeeeeeeeeeeeee and they are flatlining?  That rapid beeping right before the flatline is VF.   I don't think you would even be awake if you were in VF, because your heart isn't truly beating, just quivering, and if your brain isn't getting blood to it, you are out.  

Wow, my explanations are so academic.  LOL.  Hard to explain without the sound effects.  Hope that makes some sort of sense to you.

[nervouslady]

I was kind of wondering the same thing.  Doctors showed me the difference on an EKG from VT and SVT and they are markedly different.  VT looks, on an EKG, like a V - the line dips down... like
                               vvvvv

whereas, when your heart is beating normally, things look more like:

^^v^

Supra ventricular arrhythmias are arrhythmias that originate in the atria, I believe, and not the ventricles, despite the name confusion, so the EKG shows ^^ beats.

So, when they showed me my run of VT on the ECG, it looked like this:

^^V^ ^^V^  VVVVVVVVV ^^V^
(normal)       (VT)           (normal)

but SVT would show some upward lines, not all downward.

That probably made no sense but I saw a distinct difference on the ECG.  

There are different varieties of VT.  There are also some other, rare, forms of arrhtymia that look similar on ECG to VT, but, again, those are kinda rare.  I know my doc is wondering if I actually have VT because of what is presenting on my tests and because I had an atrial defect repair, so any issue from that would cause atrial arrhythmia, not VT.  But an EP did look it over and concluded it was VT so now we've got a mystery to solve...

[PikaPika88]

I think it is another type of conduction produced arrhythmia here.  

Once I was at the cardio office, I asked can I turn off my pacer?  The cardio told me, "No, you're in VF now.  The pacer is trying to pace it out!"  When I mentioned here and other heart forum, everyone said that I was wrong.  If VF, I won't be sitting and conversation in front with anyone.....  I could be lying on the floor or bed.  I properly listened wrong or the term could be SVT not VF.  Even the 12 leads EKG didn't show VF at all?  Where the term VF came from?  It was definately said from the cardio mouth.....

My EP explained to me.  I got wpw and my av node ablated (not pacemaker dependent).  When my AF and AT (not life-threatening arrhythmia) came in.  My only conduction path (accessory pathway) will pass what ever rhythm occured at the Atrial to the Ventricle.  So the pacemaker Atrial lead first pacing it out but it still can missed few beats.  It went down to ventricle and the ventricle's lead will keep pacing my ventricle.  They called double protection.  On the 12 leads EKG, only very expert cardio can verify the whole circuit.  Normal time, my pacer just sit there got nothing to do.  I got my own conduction thro accessory pathway (NOT av node).  The EKG won't show WPW either.  It is a very tricky one.

[Brooke_38]

Hi Christine...

Any time there is >30 secs of a rapidly occuring arrhythmia, is is considered "sustained" As to the seriousness of what you had going on...it really is difficult to say, not having a confirmed EKG or strip to show where it was coming from.

It could be that you have, like me, arrhythmias occuring in both (atria=SVT and ventricle=VT) During the EP study, the only way the Dr could ablate an arrhythmia is if in fact he was able to provoke it. So this can guarantee you that during your study he was in fact able to provoke and ablate which means...yes, you definitely had VT.

I am sure that you have many questions for your Dr. Do youself a favor before the appt. Make sure to write ALL your questions down. There's nothing worse than trying to keep a mental list and sure enough, the minute you walk into the appt. the list is erased from your mind. I will be interested in hearing how your appt goes...Best of luck and keep us in the loop:)

[Christine0687]

Thank you for the breakdown. That explains a lot. I will now be able to know which questions to ask when i go to my doc on wednesday!

[Christine0687]

The times that it happens to me, by the time i get to the hospital the racing stops. one time when I was in the hospital i was wearing a monitor, not sure if it was 12 leads. I did have an episode of a short burst of this rapid heartbeat. my doctor concluded that because of this short burst, the longer bursts must be the same just a longer version. He said i have ventricular tachycardia. I am not sure if this is considered "SVT".
Usually when the racing comes, i have many episodes in a row. like 30 seconds or less of the rapid and then back to regular. the time i went to the hospital, i didn't time it but it felt like longer than 30 seconds before it went back to a normal rate. Does this mean it not unsustained and more serious?
I did have an EP study and ablation. I have many questions for the doc when i go on Wednesday.

[Brooke_38]

Hello...

It is probably unlikely that your arrhythmia was misdiagnosed. These 3 arrhythmias may all feel the same to you, but they show very different characteristics on an EKG.

Atrial Fib originates from the upper 2 chambers (atria) and is usually a NCT (narrow complex tachycardia) meaning that each complex (P,QRS,and T wave) are very close to each other on the EKG appearing as an irregularly, irregular (rate and rhythm) arrhythmia.

V-Tach originates in the lower 2 chambers (ventricles) and always appears as a WCT (wide complex tach) which is the opposite of what I describes an NCT to be. The complexes appear spaced oot. The rate and rhythm are irregulary,regular. Very fast but with a regular rhythm.

However, sometimes (not often) VT can be confused with Afib Aberrancy, aberrant conduction and aberration are  terms used to describe an abnormal conduction of electrical impulses through the heart. These waywardly conducted signals of SVT take longer to transmit through the myocardium, and consequently produce a wide QRS complex in an ECG. At first glance, SVTs with aberrant conduction look a lot like VT and are virtually indistinguishable from VT in a single viewing lead. When viewed on a 12 lead ECG , subtle differences help to differentiate the two rhythms.

V-fib is very unlikely to have occured. This rhythm is considered a medical emergency. If the heart is not defibrillated almost immediately, death is likely to follow within seconds of the onset of this.

Was your VT diagnosed in the EP lab?

[jondsam]

Im wondering if you were meaning to say that you were diagnosed with regular old tachycardia.  If thats the case thats no big deal, pumping you up with some beta blockers, and your good to go.

[jondsam]

Sustained Ventricular tachycardia (V-tach or VT) is a tachycardia, or fast heart rhythm that originates in one of the ventricles of the heart. This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation or VFand sudden death.  If you go into VF this is a life threating cardiac arrest, that without immediate intervention will cause certain death.  VF is the quivering of your heart instead of a pumping action.  Without blood circulating throughout your body, death happens within minutes.  VT that is sustained is also a threat because it can turn into VF and then cardiac arrest.  More than likely you have been diagnosed with Un-sustained VT, which means you probably dont stay in VT that long.  Maybe you only go into for lets say a few seconds or 10 seconds, than your heart goes back to synus rhythem.  A lot of times a condtion like that is benign.  Sometimes cardio docs treat it with some forms of medicines.  Also there are diferent types of VT, and some other types are also benign.  So some VT is benign and not to worry about.  Or some can be potentialy very dangerous.  However, V-FIB is cardiac arrest, and impending death happens within minutes.  Most of the time if you go into V-Fib your heart will not come back out of it without medical attention.  A-Fib is not truly life threating.  However, it can cause a blood clot to form which can be dangerous.  Sometimes, people with a fib have to go to the hospital for a cardioversion to make their heart go back to sinus rhythem.  It sounds like to me you just need to clarify exactly what your case is.  Hope this helps!