Analysis of the initiation of spontaneous monomorphic ventricular tachycardia by stored intracardiac electrograms
| Autor: | Marc Roelke, Brian A. McGovern, Hasan Garan, Jeremy N. Ruskin |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Tachycardia medicine.medical_specialty Adolescent Heart disease Defibrillation medicine.medical_treatment Myocardial Infarction Ventricular tachycardia Electrocardiography Heart Conduction System Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Aged Aged 80 and over Cardiac cycle medicine.diagnostic_test business.industry Middle Aged medicine.disease Anesthesia Tachycardia Ventricular cardiovascular system Cardiology medicine.symptom Electrical conduction system of the heart Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 23:117-122 |
| ISSN: | 0735-1097 |
| Popis: | Objectives. This study was designed to analyze stored intracardiac electrograms generated during spontaneous monomorphic ventricular tachycardia to examine the possible mechanisms responsible for the initiation of ventricular tachycardia in a group of postinfarction patients.Background. Implantable cardioverter-defibrillators capable of storing electrograms during an arrhythmic event provide an intracardiac electrogram analog to Holter ambulatory electrocardiographic monitoring. Such electrograms are of value in arrhythmia diagnosis and in determining the appropriateness of implantable cardioverter-defibrillator therapy and may aid in understanding the initiation of ventricular arrhythmias.Methods. We studied 73 stored electrograms in 22 postinfarction patients with spontaneous monomorphic ventricular tachycardia. Premature depolarizations before tachycardia were classified by morphology and number. Electrogram morphology was compared with the morphology of the baseline rhythm and ventricular tachycardia. Prematurity was assessed by the coupling interval and a calculated prematurity ratio.Results. During baseline rhythm, ectopic activity was present in 30 (41%) of 73 stored episodes. Ventricular tachycardia was preceded by a short-long-short sequence in 14% of episodes and by a rapid ventricular rhythm in 5.5% of episodes. The onset of ventricular tachycardia was marked by single premature depolarizations in 33 episodes (45%), by pairs in 16 (22%) and by multiple complexes in 24 (33%). Morphology was similar to that of the ensuing tachycardia in 35 episodes (48%). The mean coupling interval was 364 ms, and the mean prematurity ratio was 0.56. In all 10 episodes (14%) where the prematurity ratio was |
| Databáze: | OpenAIRE |
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