This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by WELLENS, H. J. J. Articles by DURRER, D. Search for Related Content PubMed PubMed Citation Articles by WELLENS, H. J. J. Articles by DURRER, D.

(Circulation. 1974;49:647.)
© 1974 American Heart Association, Inc.

---

Further Observations on Ventricular Tachycardia As Studied by Electrical Stimulation of the Heart

Chronic Recurrent Ventricular Tachycardia and Ventricular Tachycardia During Acute Myocardial Infarction

HEIN J. J. WELLENS M.D.¹; K. I. LIE M.D.¹; DIRK DURRER M.D.¹

¹ From the University Department of Cardiology and Clinical Physiology, Wilhelmina Gasthuis, Amsterdam, The Netherlands.

Initiation and termination of tachycardia was studied by electrical stimulation of the heart in 14 patients with ventricular tachycardia (VT) not related to acute myocardial infarction (group A) and in six patients in whom the tachycardia occurred within 24 hours after the onset of acute myocardial infarction (group B). Results favor re-entry as the mechanism of tachycardia in group A patients. In group B abnormal automaticity seems more likely. In one patient with chronic recurrent VT the arrhythmia could be terminated by a single atrial premature beat. In a patient with Wolff-Parkinson-White syndrome and old myocardial infarction, VT could be initiated by a single atrial premature beat. One patient was studied while having VT during acute myocardial infarction and again five weeks later. In the acute phase of myocardial infarction no evidence for re-entry could be obtained; during the second study, however, ventricular tachycardias could be initiated and terminated by a single ventricular premature beat fulfilling the criteria of re-entry.

Key Words: Wolff-Parkinson-White syndrome • Automaticity • Arrhythmia • Myocardial infarction • Re-entry

Submitted on September 18, 1973
Accepted on November 19, 1973