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Multiform ventricular tachycardia.

D L Ross, A W Hamer, J K Vohra

    Pacing and Clinical Electrophysiology : PACE
    |January 1, 1980
    PubMed
    Summary
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    Chronic recurrent ventricular tachycardia (VT) in coronary artery disease patients can stem from multiple re-entry circuits. Programmed stimulation revealed varied VT types, suggesting complex mechanisms and the need for tailored surgical management.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Surgery

    Background:

    • Chronic recurrent ventricular tachycardia (VT) poses a significant challenge in patients with coronary artery disease.
    • Understanding the underlying mechanisms of VT is crucial for effective therapeutic strategies.

    Observation:

    • Electrophysiological studies were conducted in three patients experiencing chronic recurrent VT linked to coronary artery disease.
    • Programmed stimulation confirmed ventricular origin and suggested re-entry mechanisms for VT induction.

    Findings:

    • Multiple VT types were observed, differing in cycle length, QRS morphology, and electrogram timing.
    • Evidence indicated re-entry circuits originating near infarcted areas, exhibiting cycle length alternation and variable conduction patterns.

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  • Multiform VT appears to result from several contributing factors, including myocardial and specialized conduction tissue involvement.

    • Implications:

    • Findings suggest that multiform VT in coronary artery disease may arise from diverse re-entry circuits.
    • A modified surgical approach is recommended for medically refractory VT when multiple types are identified.
    • This research highlights the complexity of VT mechanisms and informs potential treatment modifications.