Document Detail

Initiation of monomorphic ventricular tachycardia: electrophysiological, clinical features, and drug therapy in patients with implantable defibrillators.
MedLine Citation:
PMID:  12942483     Owner:  NLM     Status:  MEDLINE    
At least 2 distinct patterns of sustained monomorphic ventricular tachycardia (MVT) have been ascribed during analysis of stored intracardiac electrograms retrieved from implantable cardioverter defibrillators and Holter recordings in patients with ventricular arrhythmia. We aimed to investigate the electrophysiological features of MVT with different initiation patterns in patients with implantable cardioverter defibrillators and to assess whether there is a relationship of the initiation patterns of sustained MVT with clinical characteristics and efficacy of antiarrhythmic therapy. Seventy-four stored intracardiac electrograms in 21 patients (mean age of 68.2 +/- 4.2 years) with MVT were evaluated. Cardiovascular diagnosis included coronary artery disease in 85.7% of the patients. All MVT episodes were classified as those initiating with ventricular premature beats (nonsudden onset MVT) and those without ventricular ectopy preceding tachycardia (sudden onset MVT). There was significant difference in left ventricular ejection fraction between MVTs with different initiation pattern, being the lower in those with nonsudden onset (33.6% +/- 38.4% vs. 38.4 +/- 7.0%, P <.04). Ventricular tachycardia cycle length was shorter in group of MVT with nonsudden onset as compared with sudden onset (338.5% +/- 48.1% vs. 376.8% +/- 57.0%, P <.02). Tachycardia with sudden onset was associated with shorter preceding RR interval than tachycardia with nonsudden onset (821.8 +/- 136.2% vs. 748.7 +/- 107.7%, P <.01). There were no significant differences in the type of antiarrhythmic drug therapy used between groups (P >.05). Monomorphic ventricular tachycardias with nonsudden onset occurred more frequently than with sudden onset, without precipitating RR cycles shortening, are faster in rate, associating with lower ejection fraction. Monomorphic ventricular tachycardias with sudden onset are characterized by preceding shortening of RR intervals, slower cycle length, and less worsening of ejection fraction.
Bulent Gorenek; Gulmira Kudaiberdieva; Alpaslan Birdane; Omer Goktekin; Yuksel Cavusoglu; Salih Bakar; Ahmet Unalir; Necmi Ata; Bilgin Timuralp
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  36     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-08-27     Completed Date:  2004-01-22     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  213-8     Citation Subset:  IM    
Cardiology Department, Osmangazi University, Eskisehir, Turkey.
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use
Autonomic Nervous System / physiopathology
Defibrillators, Implantable
Electrocardiography / methods*
Stroke Volume / drug effects,  physiology
Tachycardia, Ventricular / drug therapy,  physiopathology*,  therapy*
Reg. No./Substance:
0/Anti-Arrhythmia Agents

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