Circulation, Vol 87, 126-134, Copyright © 1993 by American Heart Association
DJ Wilber, J Baerman, B Olshansky, J Kall and D Kopp
BACKGROUND. Sustained ventricular tachycardia in the absence of structural
heart disease may have diverse mechanisms. Termination of the tachycardia
by adenosine suggests triggered automaticity as the etiology in many of
these patients. We examined the clinical characteristics,
electrophysiological responses, and results of catheter ablation in this
patient subgroup. METHODS AND RESULTS. Intravenous adenosine terminated
sustained ventricular tachycardia in seven of 14 consecutive patients
without evidence of structural heart disease. In each of these patients,
the tachycardia had a left bundle branch block, inferior-axis QRS
configuration and occurred predominantly during stress or exertion. A
morphologically similar sustained tachycardia was induced in six of seven
patients during programmed ventricular stimulation, although day-to-day
reproducibility was poor. Signal-averaged ECGs were normal in all patients.
Imaging with 123I-metaiodobenzylguanidine did not reveal focal
abnormalities in any of five patients. A discrete site of origin was
identified in the free wall of the pulmonary infundibulum in all patients.
Limited application of direct current shocks (two patients) or
radiofrequency energy (five patients) resulted in long-term abolition of
spontaneous and inducible ventricular tachycardia in all patients.
CONCLUSIONS. Adenosine-sensitive ventricular tachycardia appears to arise
from relatively discrete sites predominantly located in the free wall of
the pulmonary infundibulum. The localized nature of this tachycardia
renders it amenable to long-term cure by catheter ablation techniques.
ARTICLES
Adenosine-sensitive ventricular tachycardia. Clinical characteristics and response to catheter ablation
Section of Cardiology, Loyola University Medical Center, Maywood, Ill 50153.
This article has been cited by other articles:
 |
|
 |
|
  Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): 1064 - 1108. [Full Text] [PDF]
|
|
|
|
|
|
Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF]
|
|
|
|
 |
|
 D. P. Zipes, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Eur. Heart J., September 1, 2006; 27(17): 2099 - 2140. [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF]
|
|
|
|
 |
|
 M C S Hall and D M Todd Modern management of arrhythmias Postgrad. Med. J., February 1, 2006; 82(964): 117 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kottkamp and G. Hindricks Right ventricular tachycardia--arrhythmogenic right ventricular cardiomyopathy or idiopathic? Eur. Heart J., May 1, 2003; 24(9): 787 - 788. [Full Text] [PDF]
|
|
|
|
 |
|
 M. N. Faddis, W. Blume, J. Finney, A. Hall, J. Rauch, J. Sell, K. T. Bae, M. Talcott, and B. Lindsay Novel, Magnetically Guided Catheter for Endocardial Mapping and Radiofrequency Catheter Ablation Circulation, December 3, 2002; 106(23): 2980 - 2985. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Kanagaratnam, G. Tomassoni, R. Schweikert, S. Pavia, D. Bash, S. Beheiry, M. Niebauer, W. Saliba, M. Chung, P. Tchou, et al. Ventricular tachycardias arising from the aortic sinus of valsalva: an under-recognized variant of left outflow tract ventricular tachycardia J. Am. Coll. Cardiol., April 1, 2001; 37(5): 1408 - 1414. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kamakura, W. Shimizu, K. Matsuo, A. Taguchi, K. Suyama, T. Kurita, N. Aihara, T. Ohe, and K. Shimomura Localization of Optimal Ablation Site of Idiopathic Ventricular Tachycardia from Right and Left Ventricular Outflow Tract by Body Surface ECG Circulation, October 13, 1998; 98(15): 1525 - 1533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Rothman, H. H. Hsia, S. F. Cossu, I. L. Chmielewski, A. E. Buxton, and J. M. Miller Radiofrequency Catheter Ablation of Postinfarction Ventricular Tachycardia : Long-term Success and the Significance of Inducible Nonclinical Arrhythmias Circulation, November 18, 1997; 96(10): 3499 - 3508. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. W F Campbell, R. Charles, J C. Cowan, C. Garratt, J. M McComb, J. Morgan, E. Rowland, and R. Sutton Clinical competence in electrophysiological techniques Heart, October 1, 1997; 78(4): 403 - 412. [Full Text] [PDF]
|
|
|
|
|
|
S. M. Markowitz, B. L. Litvak, E. A. Ramirez de Arellano, J. A. Markisz, K. M. Stein, and B. B. Lerman Adenosine-Sensitive Ventricular Tachycardia : Right Ventricular Abnormalities Delineated by Magnetic Resonance Imaging Circulation, August 19, 1997; 96(4): 1192 - 1200. [Abstract] [Full Text]
|
|
|
|
|
|
H. Kottkamp, G. Hindricks, E. Horst, T. Baal, C. Fechtrup, G. Breithardt, and M. Borggrefe Subendocardial and Intramural Temperature Response During Radiofrequency Catheter Ablation in Chronic Myocardial Infarction and Normal Myocardium Circulation, April 15, 1997; 95(8): 2155 - 2161. [Abstract] [Full Text]
|
|
|
|
|
|
H. Kottkamp, G. Hindricks, X. Chen, J. Brunn, S. Willems, W. Haverkamp, M. Block, G. Breithardt, and M. Borggrefe Radiofrequency Catheter Ablation of Sustained Ventricular Tachycardia in Idiopathic Dilated Cardiomyopathy Circulation, September 1, 1995; 92(5): 1159 - 1168. [Abstract] [Full Text]
|
|
|
|
|
|
D. Klug, A. Ferracci, F. Molin, M. Dubuc, P. Savard, T. Kus, F. Helie, R. Cardinal, and R. Nadeau Body Surface Potential Distributions During Idiopathic Ventricular Tachycardia Circulation, April 1, 1995; 91(7): 2002 - 2009. [Abstract] [Full Text]
|
|