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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Management and Prognosis of Sustained Ventricular Tachycardia in the Emergency Department: A Retrospective, Observational, Single-Centre Study

  • Francesco Salinaro1
  • Pietro Begnini1,2
  • Roberto Rordorf2
  • Santi Di Pietro1
  • Benedetta Traversi1
  • Debora Monti1
  • Andrea Simone Dedato1
  • Bruno Barcella1
  • Enrico Moi1
  • Maya Coridori3
  • Enrico Baldi2
  • Simone Savastano2
4 more authors
  • Rita Camporotondo2
  • Stefania Guida2
  • Leonardo De Luca2
  • Stefano Perlini1
  1. 1Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Department of Internal Medicine, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
  2. 2Division of Cardiology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
  3. 3Division of Paediatric Cardiology, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
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Abstract

Background/Objectives: Sustained ventricular tachycardia (VT) is a potentially life-threatening arrhythmia requiring prompt Emergency Department (ED) assessment and management. However, data on its frequency, real-world treatment, and prognosis in the ED remain limited. We aimed to describe the clinical characteristics, acute management, and short- and long-term outcomes of patients presenting with VT. Methods: We retrospectively included consecutive patients presenting to the ED between January 2018 and December 2024 with a primary diagnosis of sustained VT with a pulse. We collected baseline characteristics, hemodynamic status, underlying cardiac disease, and acute treatment. In-hospital events and 30-day and 1-year outcomes were assessed. Results: A total of 103 patients were identified, accounting for approximately 0.025% of all ED visits during the study period; 84.5% were male. Chest pain (31.1%) and palpitations (25.2%) were the most common presenting symptoms. Structural heart disease was present in 90% of the cases, predominantly of ischemic origin (61%). Nearly half of the patients (49.5%) had a prior history of VT. Electrical cardioversion was performed in 28.2% of the cases. The majority of the patients (95/103; 92%) required hospitalization. Mortality was 4.9% at 30 days and 17% at 1 year. After adjustment for age, a left ventricular ejection fraction ≤ 30% and in-hospital arrhythmic recurrence were independently associated with 1-year mortality. Conclusions: Sustained VT is an uncommon but high-risk ED presentation, mainly affecting patients with ischemic structural heart disease. A discrepancy was observed between real-world clinical practice and guideline recommendations. The substantial mortality observed, particularly among patients with impaired left ventricular function or in-hospital arrhythmic recurrence, highlights the need for prompt risk stratification and optimized, guideline-concordant acute management.

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Cite

BibTeXRIS
BibTeX
@article{salinaro2026management,
  title = {{Management and Prognosis of Sustained Ventricular Tachycardia in the Emergency Department: A Retrospective, Observational, Single-Centre Study}},
  author = {Francesco Salinaro and Pietro Begnini and Roberto Rordorf and Santi Di Pietro and Benedetta Traversi and Debora Monti and Andrea Simone Dedato and Bruno Barcella and Enrico Moi and Maya Coridori and Enrico Baldi and Simone Savastano and Rita Camporotondo and Stefania Guida and Leonardo De Luca and Stefano Perlini},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15207805},
  url = {https://www.mdpi.com/2077-0383/15/20/7805},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Management and Prognosis of Sustained Ventricular Tachycardia in the Emergency Department: A Retrospective, Observational, Single-Centre Study
AU  - Francesco Salinaro
AU  - Pietro Begnini
AU  - Roberto Rordorf
AU  - Santi Di Pietro
AU  - Benedetta Traversi
AU  - Debora Monti
AU  - Andrea Simone Dedato
AU  - Bruno Barcella
AU  - Enrico Moi
AU  - Maya Coridori
AU  - Enrico Baldi
AU  - Simone Savastano
AU  - Rita Camporotondo
AU  - Stefania Guida
AU  - Leonardo De Luca
AU  - Stefano Perlini
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15207805
UR  - https://www.mdpi.com/2077-0383/15/20/7805
AB  - Background/Objectives: Sustained ventricular tachycardia (VT) is a potentially life-threatening arrhythmia requiring prompt Emergency Department (ED) assessment and management. However, data on its frequency, real-world treatment, and prognosis in the ED remain limited. We aimed to describe the clinical characteristics, acute management, and short- and long-term outcomes of patients presenting with VT. Methods: We retrospectively included consecutive patients presenting to the ED between January 2018 and December 2024 with a primary diagnosis of sustained VT with a pulse. We collected baseline characteristics, hemodynamic status, underlying cardiac disease, and acute treatment. In-hospital events and 30-day and 1-year outcomes were assessed. Results: A total of 103 patients were identified, accounting for approximately 0.025% of all ED visits during the study period; 84.5% were male. Chest pain (31.1%) and palpitations (25.2%) were the most common presenting symptoms. Structural heart disease was present in 90% of the cases, predominantly of ischemic origin (61%). Nearly half of the patients (49.5%) had a prior history of VT. Electrical cardioversion was performed in 28.2% of the cases. The majority of the patients (95/103; 92%) required hospitalization. Mortality was 4.9% at 30 days and 17% at 1 year. After adjustment for age, a left ventricular ejection fraction ≤ 30% and in-hospital arrhythmic recurrence were independently associated with 1-year mortality. Conclusions: Sustained VT is an uncommon but high-risk ED presentation, mainly affecting patients with ischemic structural heart disease. A discrepancy was observed between real-world clinical practice and guideline recommendations. The substantial mortality observed, particularly among patients with impaired left ventricular function or in-hospital arrhythmic recurrence, highlights the need for prompt risk stratification and optimized, guideline-concordant acute management.
SN  - 2077-0383
ER  -