Idiopathic recurrent sustained ventricular tachycardia in children and adolescents

The electrophysiologic characteristics of recurrent sustained ventricular tachycardia were studied in seven pediatric patients. The mechanisms of the ventricular tachycardia were evaluated using programmed electrical stimulation. Ventricular tachycardia could be reproducibly initiated in two patients and terminated in one patient in the basal state. It could be initiated in one additional patient and terminated in two additional patients after administration of a type IB drug. In four patients, ventricular tachycardia could not be initiated or terminated by programmed electrical stimulation. The site of origin of the ventricular tachycardia determined by catheter endocardial mapping was the right ventricular outflow tract in four patients, the interventricular septum in two patients and the inferior left ventricle in one patient. The ventricular tachycardia more frequently had an automatic than a reentrant mechanism, and originated more often in the right than in the left ventricle; it was not frequently associated with structural heart disease in this group of patients.