This is a case of a 56 year-old retired US Air Force who came in the Philippines for a vacation. He had a heart attack and was diagnosed to have ventricular tachycardia having cardiac rate of 280 beats per minute. The normal cardiac rate is 60 to 100 beats per minute.

What’s good about being on the Medical Surgical floor is that you get different types of diseases. It is our first time to handle such a case. I was on PM shift and it was my first time to handle the said patient. During my 8:00 pm round, he’s vital signs were normal. He’s heart beat was in the 80s as shown in the cardiac monitor. I gave him his due diazepam to help him relax and keep is cardiac rate within normal limits.
At past 9:00 pm his watcher approached the nurse’s station telling that us that the patient’s heart rate has spiked up to 200. I immediately went to his room, took his blood pressure which was normal and manually checked his heart rate rhythm . It was racing and I am actually nearly at a loss of count. He’s asymptomatic, no pain , discomfort or shortness of breath. We sent an SMS to our fellow who came in immediately. We pushed the crash cart near the patient’s room but the fellow just ordered for an IV push of cordarone (amiodarone) . A few minutes after, the doctor ordered for another shot of cordarone and as I prepared to aspirate one in a syringe, he cancelled it because the monitor showed heart rate at 80s. I monitored him all through the night and his cardiac rate did not shoot up.
So what is ventricular tachycardia?
Ventricular tachycardia (VT) or V-tach is a rapid heartbeat that starts in the ventricles.
Ventricular tachycardia is a pulse rate of more than 100 beats per minute, with at least 3 irregular heartbeats in a row.
The condition can develop as an early or late complication of a heart attack. It may also occur in patients with:
• Cardiomyopathy
• Heart failure
• Heart surgery
• Myocarditis
• Valvular heart disease
Ventricular tachycardia can occur without heart disease. (Source: medline plus)
He was then advised to have an Implantable Cardioverter Defibrillator or ICD.
A preferred treatment for many chronic (long-term) ventricular tachycardias consists of implanting a device called implantable cardioverter defibrillator (ICD). The ICD is usually implanted in the chest, like a pacemaker. It is connected to the heart with wires.
An ICD is an electronic device that constantly monitors your heart rate and rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle. This causes the heart to beat in a normal rhythm again. The ICD may also be programmed to send a rapid burst of paced beats to interrupt the ventricular tachycardia.

The ICD has two parts: the leads and a pulse generator

Lead(s)
Monitors the heart rhythm, delivers energy used for pacing, cardioversion and/or defibrillation.

Generator
Houses the battery and a tiny computer. Energy is stored in the battery until it is needed. The computer receives information from the leads to determine what rhythm is occurring. (Sources: medline plus and clevelandclinic.com)

The implantation was successful and a day after the procedure, the patient has been discharged. He even gave us a box of Macadamia nuts which her wife and son have brought in from Hawaii.