Chronic recurrent ventricular tachycardia--an electrophysiological study.

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Chronic recurrent ventricular tachycardia (VT) poses management challenges.
• Coronary disease and intraventricular conduction defects (IVCD) are common in VT patients.
• Accurate localization of VT origin is crucial for effective therapy.

Purpose of the Study:

• To evaluate the utility of electrophysiological study (EPS) in diagnosing and managing chronic recurrent VT.
• To correlate QRS morphology during VT with the infarction site in patients with coronary disease.
• To assess the reproducibility and efficacy of pacing in inducing and terminating VT.

Main Methods:

• Electrophysiological study was performed on 17 patients with chronic recurrent VT.
• Analysis of QRS morphology to deduce the site of VT origin.
• Pacing techniques were used to induce and terminate VT.
• DC cardioversion was employed for termination when necessary.

Main Results:

• The deduced site of VT origin based on QRS morphology correlated well with the electrocardiographic evidence of old infarction.
• VT was induced by pacing in 8 patients; spontaneous VT occurred in 2.
• VT was terminated by pacing in 6 patients and by DC cardioversion in 4.
• Torsade de pointes VT was observed in 4 patients; varying VT morphologies in 3.

Conclusions:

• Electrophysiological study is beneficial in managing 14 out of 17 patients with chronic recurrent VT.
• EPS is particularly valuable for patients with IVCD, undocumented VT, or syncope.
• Accurate VT origin localization via EPS improves patient management strategies.