Idiopathic RVOT Ventricular Tachycardia: When IV Beta-Blocker Has Not Achieved Sinus Rhythm Conversion

Clinical Scenario

Idiopathic outflow tract (RVOT) ventricular tachycardia that is haemodynamically tolerated — no haemodynamic instability — yet has persisted after an initial intravenous beta-blocker trial.

Prior Treatment & Escalation Trigger

An intravenous beta-blocker was used as the first-line intervention. The treatment goal — termination of ventricular tachycardia with conversion to sinus rhythm — was not met, triggering escalation to the next step.

Next-Step Approach (partial)

The structured protocol for this situation addresses an electrical intervention approach. The complete selection criteria, clinical decision points, and stepwise algorithm are available in the full regimen.

Treatment goal: termination of ventricular tachycardia with restoration of sinus rhythm.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehac262

In patients presenting with a haemodynamically tolerated idiopathic VT, treatment with intravenous beta-blocker (RVOT VT) or verapamil (fascicular VT) is recommended.
Termination can be achieved with electrical cardioversion, anti-arrhythmic medications, or pacing techniques.

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