Chronic recurrent right and left ventricular tachycardia: Comparison of clinical, hemodynamic and angiographic findings

Pietras, Raymond J.; Mautner, Richard K.; Denes, Pablo; Wu, Delon; Dhingra, Ramesh C.; Towne, William D.; Rosen, Kenneth M.

doi:10.1016/0002-9149(77)90096-0

Cited by 60 publications

(6 citation statements)

References 40 publications

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“…[16][17][18] VAs occurring in the absence of structural heart disease or transient or reversible arrhythmogenic factors (ie, electrolyte disorders or myocardial ischemia) are considered idiopathic or of unknown cause; absence of structural heart disease is usually suggested when routine diagnostic work-up (including 12-lead ECG, transthoracic echocardiography, and noninvasive or invasive test to rule out significant coronary artery disease) is normal. 2 There is increased interest in examining whether cMRI, which may allow identification of otherwise unrecognized myocardial abnormalities, is useful for the diagnostic work-up of patients presenting with unexplained VAs.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Value of Concealed Structural Abnormalities in Patients With Apparently Idiopathic Ventricular Arrhythmias of Left Versus Right Ventricular Origin

Nucifora

Muser

Masci

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background-Routine diagnostic work-up occasionally does not identify any abnormality among patients with monomorphic ventricular arrhythmias (VAs) of left ventricular (LV) origin. Aim of this study was to investigate the value of cardiac MRI (cMRI) for the diagnostic work-up and prognostication of these patients. Methods and Results-Forty-six consecutive patients (65% males; mean age, 44±15 years) with monomorphic VAs of LV origin and negative routine diagnostic work-up were included. Seventy-four consecutive patients (60% males; mean age, 40±17 years) with apparently idiopathic monomorphic VAs of right ventricular origin served as control group. Both groups underwent comprehensive cMRI study and were followed-up for a median of 14 months (25th-75th percentiles, 7-37 months). The outcome event was an arrhythmic composite end point of sudden cardiac death or nonfatal episode of ventricular fibrillation or sustained ventricular tachycardia requiring external cardioversion or appropriate implantable cardioverter defibrillator therapy. The 2 groups of patients did not differ in age (P=0.14) and sex (P=0.57). No significant difference was observed between patients with VAs of LV origin and VAs of right ventricular origin about biventricular volumes and systolic function. cMRI demonstrated myocardial structural abnormalities in 19 (41%) patients with VAs of LV origin versus 4 (5%) patients with VAs of right ventricular origin (P<0.001). The outcome event occurred in 9 patients; myocardial structural abnormalities on cMRI were significantly related to the outcome event (hazard ratio, 41.6; 95% confidence interval, 5.2-225.0; P<0.001). identification of concealed cardiac abnormalities in patients with apparently idiopathic LV arrhythmias. Moreover, scarce data are available about the prognostic value of concealed structural abnormalities detected by cMRI in these patients. Accordingly, the aim of this study was 2-fold: (1) to investigate the value of comprehensive cardiac magnetic resonance tissue characterization imaging, including T1-weighted imaging, T2-weighted imaging, and late gadolinium enhancement (LGE) imaging, for the detection of structural changes in patients with monomorphic VAs of LV versus RV origin and negative routine diagnostic work-up; and (2) to determine the prognostic value of concealed structural abnormalities detected by cMRI in these patients. Conclusions-Myocardial Methods Patient PopulationA total of 46 consecutive patients with monomorphic VAs of LV origin (ie, frequent premature ventricular beats [PVBs] >1000/24 hours, nonsustained ventricular tachycardia [NSVT], or sustained ventricular tachycardia [SVT] with right bundle branch block [RBBB] morphology) and negative routine diagnostic work-up were included in the study. Negative routine diagnostic work-up was defined on the basis of (1) absence of systemic diseases, arterial hypertension, and diabetes mellitus; (2) absence of plasma electrolyte abnormalities; (3) normal 12-lead ECG; (4) normal 2-dimensional echocardiography; and (5) absenc...

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Section: Discussionmentioning

confidence: 99%

Prevalence and Prognostic Value of Concealed Structural Abnormalities in Patients With Apparently Idiopathic Ventricular Arrhythmias of Left Versus Right Ventricular Origin

Nucifora

Muser

Masci

et al. 2014

Circ: Arrhythmia and Electrophysiology

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show abstract

“…When ventricular tachycardia was not induced by stimulation at the right ventricular apex, the protocol was repeated at the right ventricular outflow tract. Stimulation was performed with a custom-designed programmable stimulator and an optically isolated constant current source (Bloom Associates Limited, Narberth, PA), which produced rectangular impulses 1 and programmed electrical stimulation provoked ventricular tachycardia in 10 patients (figure 2). Ventricular tachycardia was initiated by atrial pacing in seven patients, ventricular pacing in five patients, and ventricular extrastimuli in seven patients and tachycardia was induced by more than one method in eight patients.…”

Section: Methodsmentioning

confidence: 99%

Right ventricular tachycardia: clinical and electrophysiologic characteristics.

Buxton¹,

Waxman²,

Marchlinski³

et al. 1983

Circulation

336

136

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“…24), 25) In an intraoperative epicardial and endocardial mapping study in patients with recurrent VT after myocardial infarction, Horowitz et al26) observed that the QRS morphology of PVBs during VT depended on the site of the earliest break-through and subsequent ventricular activation and was largely independent of the site of origin.…”

Section: Discussionmentioning

confidence: 99%

Morphology of ectopic ventricular beats and their relationship to ventricular tachycardia in acute myocardial ischemia.

et al. 1985

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Chronic recurrent right and left ventricular tachycardia: Comparison of clinical, hemodynamic and angiographic findings

Cited by 60 publications

References 40 publications

Prevalence and Prognostic Value of Concealed Structural Abnormalities in Patients With Apparently Idiopathic Ventricular Arrhythmias of Left Versus Right Ventricular Origin

Prevalence and Prognostic Value of Concealed Structural Abnormalities in Patients With Apparently Idiopathic Ventricular Arrhythmias of Left Versus Right Ventricular Origin

Right ventricular tachycardia: clinical and electrophysiologic characteristics.

Morphology of ectopic ventricular beats and their relationship to ventricular tachycardia in acute myocardial ischemia.

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