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[Pathophysiology of ventricular tachyarrhythmias]
Abstract:
On 11 patients at the age between 11 and 60 years with ventricular tachyarrhythmias (6 times relapsing ventricular tachycardia, twice relapsing ventricular fibrillation, 3 times massive polytopic ventricular extrasystoles) complex intracardiac electrophysiological and haemodynamic examinations, including heart catheterization with angiography (and in 6 patients selective coronarography) were performed. In no case we succeeded in evoking a ventricular tachycardia by stimulation. Also the spontaneous long-lasting ventricular tachycardias could not be interrupted by a single or manifold stimulation. By multiple right- and left-ventricular potential deviations we succeeded in differentiating the ventricular tachycardia and ventricular extrasystoles, respectively, according to the place of origin in all patients. As cause of the ventricular tachycardia and of the ventricular fibrillation, respectively, in 4 patients an ectopic focus with increased impulse formation, in the other patients, apart from an increased ectopic automatism, also reentry tachycardia is assumed.