Ten‐Years Follow‐Up of 20 Patients with Idiopathic Ventricular Tachycardia

Abstract

The follow-up and characteristics of 20 patients with ventricular tachycardia (VT) and no detectable heart disease is reported. These were 16 men and four women with a mean age of 44 years. Symptoms were present in 18 patients (eight had syncope and ten palpitations or dizziness), VT was sustained in 11 patients and a left bundle branch block morphology with inferior axis was found in 17 patients. In three patients, VT had a right bundle branch block morphology and left-axis deviation. The VT was inducible in 13 patients during the electrophysiological testing (EP) and was sustained in five patients. Medical treatment was introduced in 19 patients. During a mean follow-up of 10 years from the onset of the symptoms and 6 years from the EP testing, one patient died suddenly. He had stopped taking amiodarone 5 months before. In seven patients symptoms recurred and were due to discontinuation of therapy in two cases and inefficacy of previous effective treatment in five patients. After modification of the treatment (three cases), implantation of a pacemaker (one case) and catheter ablation (one case), all patients became asymptomatic. Eleven patients became asymptomatic with the first administered antiarrhythmic therapy. One patient continues to be asymptomatic in spite of discontinuation of his medical therapy. We conclude that patients with VT and no detectable heart disease have a good long-term prognosis and that appropriate therapy can be found in almost all patients.

Clinical characteristics and catheter ablation of left ventricular outflow tract tachycardia

“…Calcium channel blockers (diltiazem and verapamil) are also well tolerated, although somewhat less efficacious, with successful outcome seen in 25% to 50% of the population treated. The two drugs, when combined, show synergistic anti-arrhythmic interactions [44,45]. Class I antiarrhythmic agents (IA agents such as procainamide and IC agents such as flecainide and encainide) are effective in 25% to 50% of the patients, as are class III agents such as sotalol [10,19,45].…”

Management of ventricular tachycardia in patients with clinically normal hearts

“…The prognosis of RVOT tachycardia is generally very good; rare cases of sudden death have been reported, however [14][15][16][17]. Although longstanding tachycardia can lead to a tachycardia-induced cardiomyopathy, a relatively benign, nonprogressive clinical course is the norm.…”

Idiopathic Premature Ventricular Contraction Originating from Left Epicardial Outflow Tract —Effects of Antiarrhythmic Drugs, Autonomic Provocation and Radiofrequency Catheter Ablation—

“…Although premature ventricular contractions (PVCs) and ventricular tachycardia (VT) in the structurally normal heart are not always associated with life-threatening consequences, 1) they are sometimes refractory to antiarrhythmic agents and their symptoms are often severe. There have been some reports of catheter ablation of PVCs and VT originating from the left ventricular outflow tract (LVOT), in which the success rate of catheter ablation was high and this method of treatment was thought to be effective for eliminating these arrhythmias.…”