T he hemodynamic response to ventricular tachycardia is an important determinant of prognosis.’ Many factors determine the hemodynamic response to ventricular tachycardia, including (1) the rate of the ventricular tachycardia,2*3 (2) systolic and diastolic ventricular function,4J and (3) the neurohumoral response to the arrhythmia.6v7 Antiarrhythmic drugs such as quinidine and amiodarone may ei...

We performed a prospective, randomized crossover study to evaluate the comparative efficacy of transvenous cardioversion and rapid ventricular pacing for termination of induced ventricular tachycardia in patients with spontaneous ventricular tachycardia and organic heart disease. Sixtytwo episodes of ventricular tachycardia were induced in 15 patients, mean age 60 + 10 years, during electrophys...

Mapping-guided endocardial resection has proved to be an effective therapy for recurrent sustained ventricular tachycardia. However, some patients cannot be mapped during ventricular tachycardia, so that guidance from findings during normal sinus rhythm would be highly desirable. We examined the frequency, timing, and duration of several abnormal types of electrograms recorded endocardially dur...

BACKGROUND Conventionally, monomorphic sustained ventricular tachycardia in patients with remote myocardial infarction is believed to originate from the subendocardium. In a previous study, we demonstrated that electrical activation patterns during ventricular tachycardia occasionally suggest a subepicardial rather than subendocardial reentry. METHODS AND RESULTS This study prospectively eval...

INTRODUCTION AND OBJECTIVES We sought to demonstrate the mode of spontaneous onset of sustained monomorphic ventricular tachycardia in patients with Chagas' cardiomyopathy. METHODS We studied 222 stored electrograms in 14 patients with Chagas cardiomyopathy and spontaneous monomorphic ventricular tachycardia treated with a cardioverter defibrillator. Premature ventricular complexes before ven...

OBJECTIVES This study demonstrates that exercise-provocable tachycardia resembling right ventricular outflow tract tachycardia may originate from the anterobasal left ventricle. BACKGROUND Reentry is the operative mechanism of idiopathic left ventricular tachycardia, with a QRS complex of right bundle branch block and superior axis that is responsive to verapamil but not adenosine. Whether so...

The electrophysiologic actions of disopyramide phosphate on reentrant ventricular tachycardia induced by premature ventricular stimuli were evaluated in conscious dogs 2 to 4 days after myocardial infarction. Disopyramide was administered as a series of intravenous infusions to obtain successive steady state plasma disopyramide concentrations of 1.02 +/- 0.02, 2.05 +/- 0.08, 3.94 +/- 0.09 and 7...

Arrhythmia Mechanisms and Therapy. An understanding of the mechanisms responsible for experimental and clinical arrhythmias has led to the development of mechanism-specific therapies for ventricular tachycardia. These include: (1) beta blockade for catecholamine-sensitive ventricular tachycardia; (2) verapamil for ventricular tachycardia possibly due to triggered activity; (3) pacing, isoproter...

All eight stages of a stimulation protocol that used one then two extrastimuli from the right ventricular apex in sinus rhythm and three ventricular drive rates (100, 120, and 140 beats/min) were performed in 24 patients with recurrent spontaneous sustained ventricular tachycardia despite drug treatment. Twenty two of the patients had sustained a previous myocardial infarct and 18 were on long ...