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Polymorphous ventricular tachycardia: clinical features and treatment.
The American Journal of Cardiology
|August 1, 1979
Summary
Polymorphous ventricular tachycardia, a dangerous arrhythmia, often arises in patients with severe heart disease taking antiarrhythmic drugs. Temporary pacing and isoproterenol are effective treatments for this drug-induced condition.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Polymorphous ventricular tachycardia (PVT) is a life-threatening arrhythmia.
- PVT is characterized by QRS complex alternations, variable R-R intervals, and rapid heart rates (150-300 bpm).
Observation:
- Thirty-four PVT cases were analyzed, with most patients having severe myocardial disease.
- Drug administration, including antiarrhythmics (quinidine, procainamide), antianginals (prenylamine), and antidepressants (thioridazine), precipitated PVT.
- A prolonged corrected Q-T interval was observed in nearly all patients prior to PVT onset.
Findings:
- Antiarrhythmic drug use in patients with severe heart disease and premature ventricular complexes increases PVT risk.
- Lidocaine and cardioversion were effective only for short, isolated PVT episodes.
- Temporary ventricular pacing (100-140 bpm) and intravenous isoproterenol were the most successful treatments, resolving PVT in 17 and 10 patients, respectively.
Implications:
- Clinicians should exercise caution when prescribing antiarrhythmic drugs to patients with severe myocardial disease, particularly those with multiform premature ventricular complexes.
- Monitoring for Q-T interval prolongation is crucial in patients at risk for PVT.
- Effective management strategies for PVT include temporary pacing and isoproterenol infusion.