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Related Experiment Videos

Ventricular arrhythmias in normal hearts.

B B Lerman1, K M Stein, S M Markowitz

  • 1Department of Medicine, New York Hospital-Cornell University Medical Center, New York, USA. blerman@mail.med.cornell.edu

Cardiology Clinics
|June 13, 2000
PubMed
Summary

Idiopathic ventricular tachycardia (VT) has two main types: one from the right ventricle sensitive to adenosine, and another from the left posterior fascicle sensitive to verapamil. Both are treatable with radiofrequency ablation.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Idiopathic ventricular tachycardia (VT) is a significant cause of arrhythmia.
  • Two primary forms of idiopathic VT have been identified, differing in origin and mechanism.

Purpose of the Study:

  • To describe the characteristics of the two main forms of idiopathic VT.
  • To highlight the therapeutic implications for these arrhythmias.

Main Methods:

  • Clinical observation and electrophysiological study of patients with idiopathic VT.
  • Pharmacological testing (adenosine, verapamil) to differentiate VT mechanisms.
  • Radiofrequency catheter ablation as a treatment modality.

Main Results:

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  • The most common form originates in the right ventricular outflow tract, presenting as monomorphic or exercise-induced VT, sensitive to adenosine, and likely due to cAMP-mediated triggered activity.
  • The second major form is verapamil-sensitive intrafascicular re-entrant tachycardia, typically originating near the left posterior fascicle.
  • Both forms demonstrated successful treatment outcomes with radiofrequency catheter ablation.

    • Conclusions:

    • Idiopathic VT encompasses distinct mechanisms and origins, primarily right ventricular outflow tract triggered activity and left posterior fascicle re-entry.
    • Adenosine and verapamil sensitivity are key differentiating factors.
    • Radiofrequency catheter ablation offers an effective treatment for both predominant forms of idiopathic VT.