Nonclinical ventricular tachycardia in the Wolff-Parkinson-White syndrome.
Between September 1980 and June 1984 we assessed the specificity of induction of ventricular tachycardia (VT) with one or two ventricular extrastimuli in a consecutive series of 148 patients undergoing electrophysiological assessment for the Wolff-Parkinson-White (WPW) syndrome by standard electrophysiological techniques. Fifteen patients (10%) had six or more beats of VT induced by one ventricular extrastimulus after a ventricular drive (9 patients), two ventricular extrastimuli during reciprocating tachycardia (6 patients), and during a single atrial extrastimulus (1 patient). None of the six men and nine women, aged 16-61 years, had apparent heart disease. VT lasted for 20 +/- 14 (mean +/- standard deviation) cycles with a cycle length of 235 ms +/- 27 and was generally polymorphic. One patient had ventricular fibrillation. These patients were compared to 15 age- and sex-matched patients studied in the same time period. There was no difference in anterograde effective refractory period of the accessory pathway (316 +/- 92 vs 319 +/- 68 ms), ventricular effective refractory period (218 +/- 12 vs 227 +/- 23), shortest pacing cycle length maintaining 1:1 anterograde conduction over the accessory pathway (306 +/- 132 vs 320 +/- 67) or minimum R-R interval between preexcited beats during atrial fibrillation (280 +/- 68 vs 294 +/- 105). All patients are alive and well over a follow-up interval of 20 +/- 11 months on no antiarrhythmic therapy (13 patients) or on propranolol (2 patients).(ABSTRACT TRUNCATED AT 250 WORDS)
Milstein
S
S
Sharma
A D
AD
Klein
G J
GJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004558:Electric Stimulation; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013610:Tachycardia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications* / Q000503:physiopathology