Loading…

Analysis of the Pattern of Initiation of Sustained Ventricular Arrhythmias in Patients with Implantable Defibrillators

Initiation of Sustained Ventricular Arrhythmias. Introduction: The purpose of this study was to analyze the pattern of initiation of sustained ventricular arrhythmias in patients with varying types of underlying structural heart disease. Methods and Results: The study group consisted of 90 patients...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2000-07, Vol.11 (7), p.719-726
Main Authors: TAYLOR, ERIC, BERGER, RONALD, HUMMEL, JOHN D., DINERMAN, JAY L., KENKNIGHT, BRUCE, ARRIA, AMELIA M., TOMASELLI, GORDON, CALKINS, HUGH
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Initiation of Sustained Ventricular Arrhythmias. Introduction: The purpose of this study was to analyze the pattern of initiation of sustained ventricular arrhythmias in patients with varying types of underlying structural heart disease. Methods and Results: The study group consisted of 90 patients with an implantable cardioverter defibrillator. Cardiovascular diagnoses included coronary artery disease in 64 patients (71%). The patients were divided into four groups based on the type and severity of structural heart disease. Two hundred sixty episodes of sustained ventricular arrhythmias were analyzed. The mean coupling interval of the initiating heat of all ventricular arrhythmias was 523 ± 171 msec. The coupling interval of the initiating beat was longer in patients with impaired ventricular function, particularly those with nonischemic dilated cardiomyopathy. The prematurity index was similar regardless of the type of underlying structural heart disease. However, the prematurity index was shorter in patients with polymorphic ventricular tachycardia (VT) compared to those with monomorphic VT. A pause was observed more commonly before the onset of polymorphic VT/ventricular fibrillation than sustained monomorphic VT. Two hundred twenty‐two (85%) of the arrhythmia episodes were initiated by a late‐coupled premature beat, 33 (13%) were initiated by an early‐coupled premature beat, and 5 episodes (2%) were initiated with a short‐long‐short sequence. The patttern of initiation of the ventricular arrhythmias was similar in all patient groups and for both monomorphic and polymorphic tachycardias. Conclusion: These findings demonstrate that sustained ventricular arrhythmias typically are initiated by late‐coupled ventricular premature depolarizations, regardless of the type or severity of underlying structural heart disease or resultant arrhythmia.
ISSN:1045-3873
1540-8167
DOI:10.1111/j.1540-8167.2000.tb00040.x