Exercise-induced ventricular tachycardia

Alpert, Bruce S.; Boineau, John P.; Strong, William B.

doi:10.1007/bf02265617

Cited by 14 publications

(4 citation statements)

References 27 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…22 The efficacy and dose adjustment of the antiarrhythmic therapy is confirmed by exercise stress testing. [29][30][31] In the patient reported here, the possibility of structural heart disease was ruled out by appropriate testing, including transthoracic echocardiography, cardiac magnetic resonance imaging, cardiac catheterization, coronary angiography, and endomyocardial biopsy. The electrocardiogram was within normal limits.…”

Section: Discussionmentioning

confidence: 99%

Exercise-Induced Bidirectional Ventricular Tachycardia with Alternating Right and Left Bundle Branch Block-Type Patterns

Khan¹

2002

Angiology

View full text Add to dashboard Cite

Exercise-induced ventricular tachycardia in young adults may occur with various structural heart diseases or with structurally normal heart. The structural heart diseases reported to cause exercise-induced ventricular tachycardia in this patient population include arrhythmogenic right ventricular dysplasia, hypertrophic cardiomyopathy, dilated cardiomyopathy, myocarditis, congenital heart disease, and myocardial ischemia. The conditions well identified to cause exercise-induced ventricular tachycardia with structurally normal heart are congenital long-QT syndrome and familial polymorphic ventricular tachycardia. Exercise-induced ventricular tachycardia may display polymorphic, monomorphic, or bidirectional morphologies. A case of exercise-induced catecholamine-sensitive bidirectional ventricular tachycardia with alternating right and left bundle branch block patterns is reported in a young boy in the absence of structural heart disease, the conditions causing bidirectional ventricular tachycardia, and family history of such an event or sudden cardiac death. The bidirectional tachycardia typically displays right bundle branch block in right precordial leads with alternating polarity of the QRS-complex in frontal plane leads but in this case the bidirectional morphology of tachycardia was caused by alternating right and left bundle branch block-type patterns. The conditions causing bidirectional ventricular tachycardia are digoxin toxicity, ischemic heart disease, hypokalemia, myocarditis, and familial polymorphic ventricular tachycardia syndrome but the exact cause in this patient remained obscure, and the possibility of an underlying electrical or ion channel disease of the heart could not be ruled out.

show abstract

Section: Discussionmentioning

confidence: 99%

Exercise-Induced Bidirectional Ventricular Tachycardia with Alternating Right and Left Bundle Branch Block-Type Patterns

Khan¹

2002

Angiology

View full text Add to dashboard Cite

show abstract

“…

Case 1 .

…”

mentioning

confidence: 97%

Postexercise ventricular tachycardia in children

Feigl

1986

Pediatr Cardiol

View full text Add to dashboard Cite

Exercise-induced ventricular tachycardia (VT) in children has been reported in your journal [1] and in other publications [2,4,5] . We should like to describe two children in whom VT was depressed during effort, but became most pronounced during the recovery period .Case 1 . A 14-year-old boy complained of intermittent palpitations, especially after exertion . No signs of organic heart disease were detected . The resting electrocardiogram (ECG) showed sinus rhythm, with short runs (3-8 complexes) of VT after each 3rd-5th sinus beat . On repeated bicycle exercise testing, the ventricular arrhythmia gradually diminished and was abolished completely once the sinus rate exceeded 115 beats per minute (bpm) ; I min after stopping the exercise testing, runs of VT at a rate of 130-140 bpm and lasting for 1-2 min were recorded . They were accompanied by dizziness . A 24-h dynamic electrocardiographic tape recording showed similar results, namely, short runs of VT during rest or mild exercise, its abolition during effort, and runs of sustained VT on recovery . Amiodarone at a loading dose of 600 mg daily and a maintenance dose of 200 mg daily was fully effective in suppressing the arrhythmia .Case 2 . A 14-year-old girl complained of severe vertigo following effort . Physical and echocardiographic examinations of the heart disclosed no signs of organic heart disease . The resting ECG disclosed multiple ventricular premature complexes (VPCs) and infrequent runs of 3-4 successive VPCs (VT). The arrhythmia was completely abolished during exercise testing and on spontaneous effort . Runs of VT lasting 20-30 s at a rate of 108 bpm were recorded during the first 2-3 min of the recovery period . Amiodarone was given in the same schedule as in case I and was, likewise, fully effective in abolishing the arrhythmia .Overdrive suppression of ventricular arrhythmias is a well-recognized phenomenon . It was noted that an aggravation of the arrhythmia may be observed during the recovery period [6]. The two patients described here reported dizziness and even near syncope after effort. In both of them, overdrive suppression of VPCs and short runs of VT were recorded, but relatively long runs of VT developed in both of them 1-3 min after the abrupt cessation of effort . This phenomenon may be explained on the Pediatric Cardiology n Springer-Verlag New York Inc . 1986 basis of elevated levels of catecholamines acting on the now "unprotected" myocardium .Amiodarone was effective in both cases . It was preferred to beta-blocking drugs for the following reasons: (a) Its very long-acting effect partially solves the problem of the poor compliance of children with relatively few symptoms . (b) Only a few side effects, all of them reversible, were reported in a large series of children treated with the drug [3] .However, the relatively short experience with amiodarone and reports on possible serious and irreversible side effects (like pulmonary fibrosis) makes it mandatory to try to stop the drug as soon as possible or to substitute other effec...

show abstract

“…While other studies have examined the significance of exercise-induced ventricular tachycardia in the pediatric age group, the efficacy of graded exercise stress testing as either a precipitating stimulus or a predictive tool in recurrent pediatric SVT has been minimally explored. No data related to the efficacy of graded exercise stress testing in eliciting SVT have been published (2)(3)(4)(5)(6). The purpose of the present study was to assess the efficacy of graded exercise stress testing in eliciting SVT among patients with an established or presumed SVT predisposition.…”

mentioning

confidence: 99%