title: Clinical spectrum of fascicular tachycardia.
abstract: OBJECTIVE
  Ventricular tachycardia spreading from the anterior or posterior division of the left bundle branch is generally called fascicular tachycardia (FT). We will present our experience with FT, a type of ventricular tachycardia not necessarily implying the absence of heart disease and/or sensitivity to selective antiarrhythmic drugs, but only particular routes of left ventricular depolarization.
  
  
  METHODS
  Since 1981 we have had the opportunity to study 10 cases of FT (nine men and one woman; aged 28-77 years, mean ± SD 55 ± 18.6 years) by means of echocardiography, coronary angiography (seven cases), endomyocardial biopsy (five cases), signal-averaged electrocardiogram (SAECG, nine patients), electrophysiological and electropharmacological evaluation.
  
  
  RESULTS
  Seven patients had paroxystic, extrastimulus inducible FT that was sensitive to verapamil given intravenously (group A); three patients, on the other hand, showed repetitive or incessant FT, not modifiable by stimulation techniques and sensitive to class 1 antiarrhythmic drugs (group B). Patients presented histologic substrates ranging from the absence of heart disease to previous myocardial infarction or myocarditis. FT spontaneously disappeared within 2 years in group B, while frequently persisted in the long term in group A.
  
  
  CONCLUSIONS
  FT is not a homogeneous group of ventricular tachycardia, as patients may differ according to clinical presentation, mechanisms that are involved in the genesis of the arrhythmia and natural history; the histologic substrate is highly variable, ranging from the total absence of heart disease to severe forms of myocardial involvement.
authors: aStruttura Complessa di Cardiologia, Dip. Emergenza, ASS n2 Isontina, Ospedale di Monfalcone, Monfalcone bCentro Cardiovascolare, ASS n1 Triestina, Trieste cStruttura Complessa di Cardiologia, Dip. Cardio-Toracico, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine dStruttura Complessa di Cardiologia, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Trieste, Trieste, Italy.
authors: Tullio
authors: T
authors: Morgera
authors: Enzo
authors: E
authors: Hrovatin
authors: Carmine
authors: C
authors: Mazzone
authors: Franco
authors: F
authors: Humar
authors: Marzia
authors: M
authors: De Biasio
authors: Alessandro
authors: A
authors: Salvi
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001706:Biopsy; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*
chemical_list: D000889:Anti-Arrhythmia Agents