[Serious ventricular arrhythmias in patients without structural heart disease. Results of electrophysiologic testing]

Invasive electrophysiological testing with programmed electrical stimulation (PES) of the heart is widely used to reproduce spontaneous ventricular tachycardia (VT). In patients with coronary heart disease it has been demonstrated, that induction of sustained monomorphic VT (SMVT) was highly predictive of an increased risk of sudden death. The value of the results of PES in patients with idiopathic VT is still controversial. In this study clinical and electrophysiological data were analyzed for 34 patients with apparently normal heart and serious ventricular arrhythmias: 17 of them (group A) had documented VT (n = 9) or VT was suspected on the basis of the presence of unexplained syncope and ventricular arrhythmias in Holter monitoring (n = 8). The other causes of syncope (carotic sinus syndrome, sick sinus syndrome, atrio-ventricular block, neurological causes) were excluded in these patients. The remaining 17 patients suffered only palpitations (group B): in 5 of them Lown's grade 4 and in 12 Lown's grade 1 or 2 ventricular arrhythmia was recorded in Holter monitoring. In both groups coronary heart disease, congenital or acquired valvular heart disease, cardiomyopathy and myocarditis were excluded by means of noninvasive (physical examination, X-ray, ultrasonocardiography, electrocardiographical stress testing) and, when needed, invasive (selective coronarography, endomyocardial biopsy) evaluations. There was no significant differences in age and sex between the groups. All patients underwent baseline drug-free electrophysiologic studies with programmed right ventricular stimulation. The end point of stimulation was the induction of SMVT.(ABSTRACT TRUNCATED AT 250 WORDS)