[Termination of idiopathic ventricular tachycardia with QRS morphology of right bundle branch block and anterior fascicular hemiblock (fascicular tachycardia) by vagal maneuvers. Presentation of 4 cases].
We present 4 patients aged 51, 19, 22 and 16 years respectively, with no overt heart disease. They complained of recurrent episodes of paroxysmal sustained tachycardia with QRS morphology of right bundle branch block and left fascicular hemiblock. The analysis of the electrocardiogram during the tachycardia and, in two cases, the electrophysiologic study showed a complete a-v dissociation and capture beats confirming the ventricular origin of the arrhythmia. In all the patients the interruption of the tachycardia was obtained by the vagal maneuvers; in two of them the tachycardia was also sensitive to verapamil iv. These cases demonstrate the efficacy of the vagal maneuvers in the termination of fascicular tachycardia and support the hypothesis of slow-response nodal-like fibers, distally displaced, as the anatomical substrate of this arrhythmia.
Buja
G
G
Cattedra e Divisione di Cardiologia dell'Università di Padova.
Folino
A
A
Martini
B
B
Canciani
B
B
Egloff
C
C
Corrado
D
D
Verlato
R
R
Miorelli
M
M
Nava
A
A
D000293:Adolescent; D000328:Adult; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000503:physiopathology*; D002346:Carotid Sinus; D004562:Electrocardiography; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D013614:Tachycardia, Paroxysmal / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014630:Vagus Nerve / Q000502:physiology*; D014636:Valsalva Maneuver
Interruzione della tachicardia ventricolare idiopatica con morfologia del QRS tipo blocco di branca destra ed emiblocco fascicolare anteriore (tachicardia fascicolare) con le manovre vagali. Presentazione di 4 casi.