Prognosis

The significance and prognosis of NSVT in patients is highly dependent on presence and severity of underlying cardiac disease. In patients without evidence of ischaemia or structural heart disease, NSVT has not been found to adversely influence prognosis.[14][15] Meanwhile, patients with ischaemic or non-ischaemic cardiac disease may require lifelong medical therapy with medications, catheter ablation, and/or implantable cardioverter defibrillator (ICD) placement.

Exercise-induced NSVT

In asymptomatic, apparently healthy people, NSVT observed during exercise was previously thought to be a normal response to exertion, but some studies suggest that it may predict coronary artery disease.[4] In addition, exercise-induced NSVT should arouse suspicion for the presence of a significant problem such as catecholaminergic polymorphic ventricular tachycardia.

NSVT in apparently healthy people

Most commonly, the tachycardia originates from the right ventricular outflow tract and may cause symptoms including palpitations and pre-syncope, but the risk of death is very low.[25][66] Tachycardia-induced cardiomyopathy can occur in the setting of frequent or incessant NSVT episodes. Genetic arrhythmias and occult cardiomyopathy may appear later in life, and long-term follow-up may be indicated.

Ischaemic and non-ischaemic NSVT

In the setting of known cardiac disease, prognosis is based on risk stratification with extent of left ventricular dysfunction playing a pivotal role. Early re-perfusion in the setting of myocardial infarction decreases the overall prevalence of NSVT, and in high-risk patients who meet accepted criteria, ICD implantation allows for continuous monitoring and long-term therapy, with evidence suggesting decreased risk of mortality.[9][10][11]

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