[Continuous ventricular tachyarrhythmia in patients without detectable organic heart disease: clinical and electrophysiologic findings].
In 22 of 335 consecutive patients (6.6%) referred for evaluation and treatment of sustained ventricular tachyarrhythmias, hemodynamic and angiographic findings revealed no structural heart disease. Entry arrhythmia was ventricular fibrillation in 10 patients and sustained ventricular tachycardia in 12 patients. A subgroup of four young patients presented with slow recurrent (during 51 +/- 43 months) sustained ventricular tachycardias that were reproducibly terminated by intravenous application of verapamil. Programmed ventricular stimulation replicated the clinical arrhythmia in nine patients (75%) with ventricular tachycardia. In five patients (50%) with ventricular fibrillation no sustained ventricular arrhythmia could be induced, and only with three extrastimuli in four of the remaining five patients. On hospital discharge, 14 patients received type III antiarrhythmic agents, five patients received type I agents, and one patient received verapamil. Two patients were discharged without medical therapy. During the following 24 +/- 9 months, four patients had recurrent sustained ventricular tachycardia. No patient died suddenly during follow-up. We conclude that about 6% of all patients with ventricular tachyarrhythmias have apparently normal hearts. These idiopathic tachyarrhythmias seem to have a benign course, at least when treated. Slow, verapamil-sensitive tachycardias of young people may represent a unique entity.
Schöls
W
W
Medizinische Universitätsklinik Heidelberg, Abteilung Innere Medizin III.
Brachmann
J
J
Schmitt
C
C
Waldecker
B
B
Kübler
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D002648:Child; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013575:Syncope / Q000209:etiology; D013610:Tachycardia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000209:etiology; D014700:Verapamil
D000889:Anti-Arrhythmia Agents; D014700:Verapamil
Anhaltende ventrikuläre Tachyarrhythmien bei Patienten ohne nachweisbare organische Herzerkrankung: klinische und elektrophysiologische Befunde.