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Studies on left ventricular function during sustained ventricular tachycardia.

S Saksena, J M Ciccone, W Craelius

    Journal of the American College of Cardiology
    |September 1, 1984
    PubMed
    Summary

    Rapid ventricular pacing and tachycardia significantly impair left ventricular systolic function, decreasing peak systolic pressure and contractility (dP/dt). Diastolic function, however, remained largely unaffected in patients with recurrent ventricular tachycardia.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Physiology

    Background:

    • Recurrent sustained ventricular tachycardia poses a significant risk to cardiac function.
    • Understanding the acute hemodynamic impact of ventricular arrhythmias is crucial for patient management.

    Purpose of the Study:

    • To investigate the acute effects of rapid ventricular pacing and sustained ventricular tachycardia on left ventricular (LV) function.
    • To analyze changes in LV systolic and diastolic pressures and their derivatives during induced arrhythmias.

    Main Methods:

    • Programmed electrical stimulation and hemodynamic measurements in 20 patients with recurrent sustained ventricular tachycardia.
    • Analysis of LV peak systolic pressure, end-diastolic pressure, and dP/dt during sinus rhythm, pacing, and induced ventricular tachycardia.

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    Main Results:

    • LV peak systolic pressure significantly decreased from 123 mmHg (sinus rhythm) to 77 mmHg during ventricular tachycardia (p<0.05).
    • Peak LV dP/dt, an index of contractility, reduced from 1400 mmHg/s to 810 mmHg/s (p<0.05) during ventricular tachycardia.
    • LV end-diastolic pressure showed no significant changes during pacing or ventricular tachycardia.

    Conclusions:

    • Rapid ventricular pacing and sustained ventricular tachycardia acutely impair left ventricular systolic function, evidenced by reduced systolic pressure and contractility.
    • Diastolic function, as assessed by LV end-diastolic pressure, appears relatively preserved during these acute arrhythmic events.