Clinical and electrophysiologic characteristics of exercise-related idiopathic ventricular tachycardia.
In 37 (70%) of 53 patients with idiopathic ventricular tachycardia (VT), episodes were mainly related to exercise (group 1). These patients were younger (33 +/- 14 vs 44 +/- 18 years, p = 0.015) and more often had dizziness during VT (71 vs 40%, p = 0.003) than the 16 patients in whom VT was not exercise-related (group 2). Patients in group 1 needed cardioversion less often to terminate the arrhythmia (4 (11%) vs 6 (40%), group 2 [p = 0.04]). VT was initiated during exercise testing in 62% of patients in group 1 but in only 1 patient in group 2 (p = 0.0004). Induction of clinical VT during programmed stimulation was observed in a similar percentage in group 1 (49%) and group 2 (50%) patients. Isoproterenol infusion facilitated the induction of VT in 9 of 20 (45%) group 1 and in 2 of 8 (25%) group 2 patients (p = not significant). After a mean follow-up of 2.9 +/- 2.5 years, 8 (22%) group 1 patients and 5 (31%) group 2 had at least 1 episode of symptomatic VT. Only 1 patient died suddenly. Class III drugs were the most useful in preventing recurrences. Beta-blocking agents were of little value in both groups. Patients with VT and a structurally normal heart have a good prognosis despite recurrences of their arrhythmia. The relation of the arrhythmia to exercise has no prognostic implications.
Mont
L
L
Department of Cardiology, Academic Hospital Maastricht, University of Limburg, The Netherlands.
Seixas
T
T
Brugada
P
P
Brugada
J
J
Simonis
F
F
Rodríguez
L M
LM
Smeets
J L
JL
Wellens
H J
HJ
D000328:Adult; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011379:Prognosis; D013610:Tachycardia / Q000188:drug therapy / Q000503:physiopathology*