Document Detail

Adenosine-sensitive ventricular tachycardia. Clinical characteristics and response to catheter ablation.
MedLine Citation:
PMID:  8418999     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sustained ventricular tachycardia in the absence of structural heart disease may have diverse mechanisms. Termination of the tachycardia by adenosine suggests triggered automaticity as the etiology in many of these patients. We examined the clinical characteristics, electrophysiological responses, and results of catheter ablation in this patient subgroup. METHODS AND RESULTS: Intravenous adenosine terminated sustained ventricular tachycardia in seven of 14 consecutive patients without evidence of structural heart disease. In each of these patients, the tachycardia had a left bundle branch block, inferior-axis QRS configuration and occurred predominantly during stress or exertion. A morphologically similar sustained tachycardia was induced in six of seven patients during programmed ventricular stimulation, although day-to-day reproducibility was poor. Signal-averaged ECGs were normal in all patients. Imaging with 123I-metaiodobenzylguanidine did not reveal focal abnormalities in any of five patients. A discrete site of origin was identified in the free wall of the pulmonary infundibulum in all patients. Limited application of direct current shocks (two patients) or radiofrequency energy (five patients) resulted in long-term abolition of spontaneous and inducible ventricular tachycardia in all patients. CONCLUSIONS: Adenosine-sensitive ventricular tachycardia appears to arise from relatively discrete sites predominantly located in the free wall of the pulmonary infundibulum. The localized nature of this tachycardia renders it amenable to long-term cure by catheter ablation techniques.
D J Wilber; J Baerman; B Olshansky; J Kall; D Kopp
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  87     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-02-08     Completed Date:  1993-02-08     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  126-34     Citation Subset:  AIM; IM    
Section of Cardiology, Loyola University Medical Center, Maywood, Ill 50153.
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MeSH Terms
Adenosine / therapeutic use*
Follow-Up Studies
Heart Catheterization*
Middle Aged
Tachycardia, Ventricular / drug therapy*,  physiopathology,  surgery
Reg. No./Substance:

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