Arrhythmia & electrophysiology

Ventricular Tachycardia & Arrhythmia claims.

Expert witness reports on missed ventricular tachycardia, misdiagnosis as supraventricular arrhythmia, or a failure to initiate guideline-directed therapy leading to sudden cardiac death.

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  • Missed VT diagnosis
  • ICD implantation delay
  • Sudden cardiac death
  • Bolam · Bolitho
what we cover

The arrhythmia and the legal questions it raises.

Ventricular tachycardia is a life-threatening arrhythmia originating below the atrioventricular node, often complicating ischaemic heart disease, cardiomyopathy or channelopathy. Prompt recognition and intervention are critical to prevent sudden cardiac death.

Most instructions arise where ventricular tachycardia was misdiagnosed as supraventricular tachycardia, where appropriate anti-arrhythmic therapy or implantable cardioverter-defibrillator implantation was delayed, or where guideline-directed management was not followed. The decisions are tested against the current NICE and ESC guidance for arrhythmia management and the prevention of sudden cardiac death.

  • Breach questions address ECG interpretation, differentiation between ventricular and supraventricular tachycardia, and the threshold for specialist electrophysiology referral.
  • Causation questions turn on whether earlier diagnosis or intervention would have prevented the sudden cardiac death or other fatal arrhythmic event on the balance of probabilities.
  • ICD implantation delay sits squarely within cardiology responsibility and is frequently in scope for both breach and causation.
  • Apportionment arises where pre-existing structural heart disease contributed to the outcome alongside the alleged breach.
Clinical scope

The clinical questions our cardiologists answer.

Reports address the electrophysiology decisions in issue against current guidance and the Bolam and Bolitho standard, prepared to CPR Part 35.

Included in scope

Questions addressed

  • Whether the 12-lead ECG demonstrated features consistent with ventricular tachycardia, and whether the differential diagnosis adequately considered life-threatening arrhythmia.
  • Whether appropriate anti-arrhythmic therapy, electrical cardioversion or implantable cardioverter-defibrillator implantation was initiated in line with the ESC guidance.
  • Whether the threshold for specialist electrophysiology referral was met and acted on within a reasonable timeframe, including same-day referral where there was haemodynamic instability.
  • Whether, on the balance of probabilities, earlier intervention would have altered the outcome, with material contribution analysis where appropriate.
  • Whether the decision to implant or defer an implantable cardioverter-defibrillator was consistent with current practice and whether delay contributed to the fatal event.
Out of scope

Not covered without separate instruction

  • Catheter ablation technique, which sits with electrophysiology instruction where procedural complications are in issue.
  • Cardiac surgical decisions where structural heart disease required intervention, addressed via cardiac surgery instruction.
  • Examination of the claimant or prognosis evaluation, which requires a separate condition and prognosis report.
  • Quantum, life expectancy and care needs, addressed through dedicated reports where the case progresses to that stage.
Common cases

Common scenarios we report on.

These patterns recur in ventricular tachycardia and arrhythmia claims, most turning on emergency department or cardiology decisions.

  • A&E · Misdiagnosis

    Ventricular tachycardia misdiagnosed as SVT

    Patient presented to A&E with palpitations and presyncope. The 12-lead ECG demonstrated broad-complex tachycardia, misinterpreted as supraventricular tachycardia, and the patient was discharged without specialist review. Sudden cardiac death followed within hours. The report addresses whether the ECG features met VT criteria and whether the guidance for immediate management was followed.

    Often paired with: Breach of Duty Causation

  • Cardiology · Delayed ICD

    Implantable cardioverter-defibrillator implantation delay

    Patient with known ischaemic cardiomyopathy and documented non-sustained ventricular tachycardia; ICD implantation was deferred on perceived clinical stability, and sudden cardiac death occurred before the scheduled procedure. The report examines whether the deferral fell below the accepted standard and whether timely implantation would have prevented the fatal event.

    Often paired with: Breach of Duty Causation

  • Electrophysiology · Misattribution

    Haemodynamically stable VT — delayed specialist referral

    Patient presented with broad-complex tachycardia and was haemodynamically stable. Managed as presumed supraventricular tachycardia without electrophysiology input; a subsequent cardiac MRI demonstrated underlying arrhythmogenic cardiomyopathy. The report addresses whether the clinical stability masked an underlying high-risk substrate warranting urgent specialist review.

    Often paired with: Screening & Merits Breach of Duty

  • Primary care · Risk factors

    Inadequate arrhythmia risk stratification

    Patient with multiple episodes of presyncope; no 12-lead ECG or Holter monitoring was performed, and a subsequent sudden cardiac death was attributed to ventricular arrhythmia. The report examines whether the symptom pattern warranted investigation and whether earlier diagnosis would have altered management on the balance of probabilities.

    Often paired with: Causation Condition & Prognosis

Reports

Report types commissioned for this condition.

These cases typically progress from screening into full liability work, with causation often the central battleground in sudden cardiac death claims.

Approaching a deadline?

Instruct an expert in ventricular tachycardia and arrhythmia.

Send a short note on the alleged failings with the records bundle. Quotation returned the same working day; fast-track available where the trial window or limitation deadline requires it.

Instruct a cardiology expert Call 0800 161 3395

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