Clinical and electrophysiologic characteristics of exercise-related idiopathic ventricular tachycardia

Mont, Lluı́s; Seixas, Tamer; Brugada, Pedro; Brugada, Josép; Simonis, Frank; Rodríguez, Luz M.; Smeets, Joep L.R.M.; Wellens, Hein J.J.

doi:10.1016/0002-9149(91)90405-a

Cited by 66 publications

(19 citation statements)

References 18 publications

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“…After the first application of radiofrequency energy, PVCs which were observed frequently prior to ablation had disappeared. (1,(8)(9)(10)(11). Idiopathic ventricular tachycardia originating from the RVOT in patients without structural heart disease is considered benign, and radiofrequency catheter ablation has become an effective therapeutic option for these arrhythmias (12)(13)(14)(15)(16) (17) or idiopathic ventricular fibrillation (18,19).…”

Section: F I G U R E 3 I N T R a C A R D I A C E L E C T R O G R A mentioning

confidence: 99%

Catheter Ablation of a Polymorphic Ventricular Tachycardia Inducing Monofocal Premature Ventricular Complex

et al. 2008

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Section: F I G U R E 3 I N T R a C A R D I A C E L E C T R O G R A mentioning

confidence: 99%

Catheter Ablation of a Polymorphic Ventricular Tachycardia Inducing Monofocal Premature Ventricular Complex

et al. 2008

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“…It originates from the right ventricular outflow tract (RVOT) and presents with left bundle branch block morphology and inferior axis on surface ECG in most patients. [1][2][3][4] It has also been recognized that verapamilsensitive VT with a right bundle branch block morphology (RBBB) can occur during exercise in apparently normal hearts. [1][2][3][4][5] A recent study has demonstrated that inflammatory left ventricular microaneurysms can be a cause of apparently idiopathic ventricular tachyarrhythmias.…”

mentioning

confidence: 99%

“…[1][2][3][4] It has also been recognized that verapamilsensitive VT with a right bundle branch block morphology (RBBB) can occur during exercise in apparently normal hearts. [1][2][3][4][5] A recent study has demonstrated that inflammatory left ventricular microaneurysms can be a cause of apparently idiopathic ventricular tachyarrhythmias. 6 We report on 4 patients with recurrent exercise-induced syncope attributable to fast VT, 1 or 2 aneurysms in the inferior-lateral wall of the left ventricle (LV), and a peculiar subepicardial arrhythmogenic substrate.…”

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confidence: 99%

An Underrecognized Subepicardial Reentrant Ventricular Tachycardia Attributable to Left Ventricular Aneurysm in Patients With Normal Coronary Arteriograms

et al. 2003

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Background-In patients with apparently normal hearts, ventricular tachycardia (VT) may only involve the subepicardial myocardium. Methods and Results-Four patients with exercise-induced fast VT with right bundle branch block morphology were investigated. ECG showed a small q wave in leads II, III, and aVF during sinus rhythm (SR) in all 4 patients. Left ventricular angiography showed small inferolateral aneurysms in all patients. Coronary arteriograms were normal in all 4 patients. Six unstable VTs (cycle length, 200 to 305 ms) and 1 stable VT (cycle length 370 ms) were reproducibly induced in the 4 patients. During SR, endocardial mapping was normal in all 4 patients, and epicardial mapping showed fragmented and late potentials in the left inferolateral wall anatomically consistent with the left ventricle aneurysm. During tachycardia, epicardial mapping showed a macroreentrant VT with focal endocardial activation in the patient with stable VT, whereas in 2 patients with unstable VT, a diastolic potential was only recorded and coincided with the late potential in the same area. Epicardial ablation was performed in 3 patients and successfully abolished those VTs. No VT recurred in 2 patients during follow-up of 2 and 9 months. Clinical VT recurred 6 months after the ablation and was successfully ablated in a repeated epicardial ablation in 1 patient. In the remaining patient without epicardial ablation, an implantable cardiac defibrillator was implanted. There were multiple shocks during a follow-up of 31 months. Conclusions-In

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“…Signal-average ECG often fails to detect late potentials. Exercise testing will reproduce the arrhythmia in less than 50% of patients 4) and right heart catheterization may reveal elevated right ventricular end-diastolic pressure, volume, and reduced RV ejection fraction in 25-45% of patients. 5) Right ventriculography and cardiac MRI are useful to rule out ARVD.…”

Section: Discussionmentioning

confidence: 99%

Multi-morphology Wide QRS Tachycardias in a Patient without Structural Heart Disease. An Unusual Presentation of Ventricular Tachycardia.

2001

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SUMMARYVentricular tachycardia occurs infrequently in patients without structural heart disease. These tachycardias commonly originate from the right ventricular outflow tract. However, the presence of more than one arrhythmogenic substrate in a patient without structural heart disease is rare. We report such a 48-year old patient with no structural heart disease who presented with three morphology wide QRS tachycardia. A brief review of the pathophysiology and management is discussed. (Jpn Heart J 2001; 42: 633-638)

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Clinical and electrophysiologic characteristics of exercise-related idiopathic ventricular tachycardia

Cited by 66 publications

References 18 publications

Catheter Ablation of a Polymorphic Ventricular Tachycardia Inducing Monofocal Premature Ventricular Complex

Catheter Ablation of a Polymorphic Ventricular Tachycardia Inducing Monofocal Premature Ventricular Complex

An Underrecognized Subepicardial Reentrant Ventricular Tachycardia Attributable to Left Ventricular Aneurysm in Patients With Normal Coronary Arteriograms

Multi-morphology Wide QRS Tachycardias in a Patient without Structural Heart Disease. An Unusual Presentation of Ventricular Tachycardia.

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