Haemodynamic effect of the suppression of ventricular tachycardia by atrio-ventricular captures

In 10 anaesthetized open chest dogs, blood pressure, electrogram from the left auricular appendage or right atrium, peripheral ECG and cardiac output were recorded. Ventricular tachycardia was produced with aconitine and then suppressed by inducing atrial fibrillation or flutter-fibrillation either with aconitine or with electrical stimulation. After the capture of the ventricles by the supraventricular impulses, a haemodynamic improvement took place. This improvement is attributed to: I) beat to beat changes in the length of the cardiac cycles, whereby intermittent strong beats arise; II) restoration of the normal ventricular activation path and time course; III) the active contribution of properly timed atrial contractions, when present. The improvement was more evident when, after the capture, the ventricular rate was lower than during the ventricular tachycardia, because of a longer period available for the ventricular filling. It is believed that the reduction of the ventricular rate immediately after the capture is due to the suppression of the activity of the ventricular ectopic focus by the concealed conduction of high rate impulses coming from the atria.