Right ventricular tachycardia: clinical and electrophysiologic characteristics.
This report describes the clinical and electrophysiologic characteristics of 30 patients without myocardial disease who had ventricular tachycardia with the morphologic characteristics of left bundle branch block and inferior axis. The tachycardias were nonsustained in 24 patients, sustained (greater than 30 sec) in six patients, and provocable by exercise in 14 of 23 patients undergoing a standard Bruce protocol. Ventricular tachycardia was induced during electrophysiologic study in 22 of 30 patients. Programmed stimulation induced tachycardia in 10 of 30 patients, most frequently by rapid atrial or ventricular pacing. Isoproterenol infusion facilitated tachycardia induction in 13 of 23 patients. Endocardial activation mapping, performed in 10 patients, confirmed that earliest ventricular activation during tachycardia occurred at the right ventricular outflow tract on the interventricular septum. These tachycardias were unique in their responsiveness to a wide variety of antiarrhythmic drugs, including type I drugs and propranolol. During a mean follow-up of 30 months, no patient has died or experienced cardiac arrest. Two patients appear to be in spontaneous remission, and no patient has developed additional signs of cardiac disease.
D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002037:Bundle-Branch Block / Q000175:diagnosis; D002304:Cardiac Pacing, Artificial; D009202:Cardiomyopathies; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D007545:Isoproterenol; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011433:Propranolol / Q000627:therapeutic use; D013610:Tachycardia / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D014700:Verapamil / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D011433:Propranolol; D014700:Verapamil; D007545:Isoproterenol