Which of the following implies a better prognosis during an episode of V-tach?

Which of the following implies a better prognosis during an episode of V-tach?

• A. Monomorphic V-tach
• B. Polymorphic V-tach
• C. Rapidly changing V-tach
• D. Multifocal V-tach

Answer: (A)

Monomorphic ventricular tachycardia (V-tach) is characterized by a consistent appearance of QRS complexes on the ECG, indicating that the rhythm originates from a single focus within the ventricles. This uniformity suggests that the underlying mechanism is more stable and less likely to be associated with significant underlying heart disease compared to other types of V-tach.

The presence of monomorphic V-tach often correlates with better hemodynamics and responses to treatment, making it easier to manage. Patients experiencing monomorphic V-tach are typically at lower risk of pulsless electrical activity and can often tolerate the arrhythmia for a longer period without severe complications.

In contrast, polymorphic V-tach, rapidly changing V-tach, or multifocal V-tach indicate more chaotic electrical activity in the heart, which may stem from underlying severe cardiac issues and generally carries a worse prognosis. These forms of V-tach can be more unpredictable and harder to treat, leading to increased morbidity and mortality. Therefore, the presence of monomorphic V-tach suggests a more favorable clinical situation and shorter-term prognosis.