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Related Experiment Videos

Multiform ventricular ectopic rhythm. Evidence for multiple parasystolic activity.

N El-Sherif, P Samet

    Circulation
    |March 1, 1975
    PubMed
    Summary
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    Multiform ventricular ectopic rhythm in patients with heart disease may stem from multiple parasystolic foci firing simultaneously. This complex arrhythmia often resists treatment and is linked to heart failure mortality.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Internal Medicine

    Background:

    • Multiform ventricular ectopic rhythm is a complex arrhythmia often seen in patients with advanced organic heart disease.
    • Patients typically present with significant intraventricular conduction defects, such as left bundle branch block.
    • This arrhythmia is frequently resistant to standard antiarrhythmic therapies.

    Purpose of the Study:

    • To investigate the underlying mechanisms of multiform ventricular ectopic rhythm in patients with severe heart disease.
    • To determine the relationship between this arrhythmia and patient mortality.
    • To explore the role of parasystolic foci in generating multiform ventricular activity.

    Main Methods:

    • Retrospective analysis of electrocardiograms and long rhythm strips from six patients with multiform ventricular ectopic rhythm.

    Related Experiment Videos

  • Detailed examination of ventricular ectopic activity to identify the number and characteristics of parasystolic foci.
  • Correlation of arrhythmia patterns with patient outcomes, including mortality and response to antiarrhythmic drugs.

    • Main Results:

    • Analysis revealed concurrent discharge from multiple parasystolic foci (3-6 per patient, 24 total) contributing to the multiform ventricular activity.
    • QRS configuration of parasystolic foci remained constant, but rhythm varied with drugs or clinical status in most cases.
    • Fourteen parasystolic foci exhibited exit block, including examples of rapid parasystole with high-degree exit block.

    Conclusions:

    • Multiform ventricular ectopic rhythm may result from the simultaneous activation of multiple parasystolic foci.
    • The observed arrhythmia was associated with mortality from terminal heart failure, not sudden death, in this cohort.
    • Parasystole with exit block is a significant factor in the complex ventricular arrhythmias observed in advanced heart disease.