Two-dimensional echocardiographic studies during sustained ventricular tachycardia.

Area of Science:

• Cardiology
• Medical Imaging

Background:

• Recurrent sustained ventricular tachycardia (VT) poses a significant threat to cardiac function.
• Assessing left ventricular (LV) function during VT is crucial for understanding its hemodynamic impact.

Purpose of the Study:

• To evaluate left ventricular function in patients with recurrent sustained VT using two-dimensional echocardiography (2DE).
• To analyze changes in wall motion, mitral valve function, and ejection fraction (EF) during VT compared to sinus rhythm (SR).

Main Methods:

• Two-dimensional echocardiography (2DE) was performed on 13 patients (11 men, 2 women; age 42-77) in sinus rhythm (SR) and during induced VT.
• Analysis included LV wall motion, mitral valve leaflet motion, and ejection fraction (EF).
• Doppler echocardiography was used in one patient to assess mitral flow patterns.

Main Results:

• In SR, 12 patients had wall motion abnormalities (WMA); 2 new WMA appeared during VT, and 8 showed worsening of existing WMA.
• LV ejection fraction (EF) decreased significantly during VT (mean 36% in SR to 21% after 10 beats and 19% after 20 beats).
• EF reduction was more pronounced in patients with shorter VT cycle lengths; mitral valve opening became intermittent.

Conclusions:

• Sustained VT markedly impairs left ventricular function, evidenced by reduced ejection fraction and increased wall motion abnormalities.
• The degree of functional impairment correlates with VT cycle length, suggesting a direct impact on cardiac mechanics.
• 2DE is a valuable tool for assessing LV dysfunction during VT episodes.