Circulation, Vol 68, 917-927, Copyright © 1983 by American Heart Association
AE Buxton, HL Waxman, FE Marchlinski, MB Simson, D Cassidy and ME Josephson
This report describes the clinical and electrophysiologic characteristics
of 30 patients without myocardial disease who had ventricular tachycardia
with the morphologic characteristics of left bundle branch block and
inferior axis. The tachycardias were nonsustained in 24 patients, sustained
(greater than 30 sec) in six patients, and provocable by exercise in 14 of
23 patients undergoing a standard Bruce protocol. Ventricular tachycardia
was induced during electrophysiologic study in 22 of 30 patients.
Programmed stimulation induced tachycardia in 10 of 30 patients, most
frequently by rapid atrial or ventricular pacing. Isoproterenol infusion
facilitated tachycardia induction in 13 of 23 patients. Endocardial
activation mapping, performed in 10 patients, confirmed that earliest
ventricular activation during tachycardia occurred at the right ventricular
outflow tract on the interventricular septum. These tachycardias were
unique in their responsiveness to a wide variety of antiarrhythmic drugs,
including type I drugs and propranolol. During a mean follow-up of 30
months, no patient has died or experienced cardiac arrest. Two patients
appear to be in spontaneous remission, and no patient has developed
additional signs of cardiac disease.
ARTICLES
Right ventricular tachycardia: clinical and electrophysiologic characteristics
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