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Related Experiment Videos

Recurrent sustained ventricular tachycardia. 1. Mechanisms.

M E Josephson, L N Horowitz, A Farshidi

    Circulation
    |March 1, 1978
    PubMed
    Summary

    This study suggests re-entry is the primary mechanism behind recurrent sustained ventricular tachycardia (VT). Programmed electrical stimulation reproducibly initiated and terminated VT, with termination methods varying by VT rate and origin.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Arrhythmias

    Background:

    • Recurrent sustained ventricular tachycardia (VT) poses a significant clinical challenge.
    • Understanding the underlying electrophysiological mechanisms of VT is crucial for effective treatment strategies.

    Purpose of the Study:

    • To investigate and elucidate the mechanism of recurrent sustained ventricular tachycardia (VT).
    • To determine the role of re-entry in the initiation and maintenance of VT.
    • To identify factors influencing the termination of VT through programmed electrical stimulation.

    Main Methods:

    • Evaluation of 21 patients with recurrent sustained ventricular tachycardia (VT).
    • Utilized programmed electrical stimulation to assess VT initiation and termination.

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  • Analyzed the effects of ventricular premature depolarizations (VPDs) and pacing (VP) on VT.

    • Main Results:

    • Reproducible initiation and termination of VT by programmed stimulation strongly suggested re-entry as the mechanism.
    • VT termination methods were dependent on VT rate, ventricle of origin, and stimulation site.
    • The proximal His-Purkinje system was not essential for VT initiation or maintenance.

    Conclusions:

    • Re-entry is the predominant mechanism responsible for recurrent sustained ventricular tachycardia (VT).
    • Specific electrophysiological criteria, including ventricular capture and fusion beats, localized the re-entrant circuit.
    • Programmed stimulation provides valuable insights into VT mechanisms and termination patterns.