title: Electrocardiographic patterns relative to initiating mechanisms of exercise-induced ventricular tachycardia.
abstract: The initiating mechanisms of exercise-induced ventricular tachycardia were studied in a population of 5842 patients who performed 9064 bicycle exercise tests. Sixty (1%) patients had 194 episodes of ventricular tachycardia during the test. Forty-two percent of these occurred during exercise and 58% during recovery. Two different initiating electrocardiographic patterns were observed. In 17 (28%) patients ventricular tachycardia was initiated by a short-long-short sequence of R-R intervals (group 1). Thirty-eight (63%) patients did not have this pattern of interval changes preceding ventricular tachycardia (group 2). Five (8%) other patients showed both patterns. The clinical characteristics of the groups were different for angina and cardiomyopathy but not for previous myocardial infarction. In group 1 ventricular tachycardia was related to recovery (76%; p < 0.05). In group 2 tachycardia occurrence was equally divided between exercise and recovery. The electrocardiographic differences suggest that different initiating mechanisms are involved in the development of exercise-induced ventricular tachycardia. The present findings may enhance aimed drug therapy in ventricular tachycardia.
authors.affiliation: Thoraxcenter, Department of Cardiology, University Hospital Groningen, The Netherlands.
authors.forename: Y S
authors.initials: YS
authors.lastname: Tuininga
authors.forename: H J
authors.initials: HJ
authors.lastname: Crijns
authors.forename: A C
authors.initials: AC
authors.lastname: Wiesfeld
authors.forename: D J
authors.initials: DJ
authors.lastname: Van Veldhuisen
authors.forename: H L
authors.initials: HL
authors.lastname: Hillege
authors.forename: K I
authors.initials: KI
authors.lastname: Lie
mesh_terms: D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors