Anatomical origin of pressure-related ventricular ectopic rhythms

In order to determine the origin of pressure-related ectopic rhythms, the main arteries were clamped in 11 anesthetized dogs, or the arteries or veins were transfused, while on or off metaraminol. The epicardial right atrial electrogram, the intracavity electrograms and the pressure of the two ventricles were recorded. Sinus rhythm was associated with 64/64 (100%) of the control periods off metaraminol, but only 19/50 (38%) of the clamping of the main arteries (P << 0.0005). In 14/27 aortic clampings ectopic beats appeared from the left ventricle and in 13/27 from the right one. In 4/23 clampings of the pulmonary artery ectopic beats appeared from the left ventricle and in 15/23 from the right one (P < 0.05). Sinus rhythm was associated with significantly lower left ventricular systolic pressure than any ventricular arrhythmia. The left ventricular systolic pressure associated with ectopic rhythms from the left ventricle was significantly (P < 0.005) higher than that associated with those from the right ventricle. The right ventricular systolic pressure during sinus rhythm was significantly (P < 0.005) lower than that during ectopic rhythm from any ventricle. It is concluded that a rise in the pressure of one ventricle tends to cause ventricular ectopic rhythms originating predominantly, but not exclusively, from this ventricle. The origin of ventricular ectopic rhythms from the right ventricle does not preclude that the arrhythmia may respond favorably to lowering of the systemic pressure.