Prognostic Value of Ventriculoatrial Conduction on Programmed Ventricular Stimulation in Patients Suspicious for Ventricular Tachyarrhythmia

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Pacemaker and Electrophysiology, Chamran Heart Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Cardiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Assistant Professor, Department of Pacemaker and Electrophysiology, Seied-O-Shohada Heart Hospital, Orumieh University of Medical Sciences, Orumieh, Iran.

Abstract

Background: Prediction of ventricular tachycardia (VT) inducibility through clinical and paraclinical predictors and ability of ventriculoatrial (VA) conduction can help to identify high risk patients easier.Methods: Fifty four patients suspicious for ventricular tachyarrhythmia underwent electrophysiologic study for basic measurements and programmed stimulation for ventricular tachycardia induction, electrocardiography and echocardiography during October 2007-October 2009.Finding: The mean age of participants was 59.4  13.9 years. Forty three patients (79.6%) were male and 39 patients (72.2%) had history of ischemic heart disease (IHD). ventricular tachycardia was induced in 30 patients (55.6%). Ventriculoatrial conduction was recorded in 38.9% of patients (21/54). Ventricular tachycardia was induced in 52.4% of patients (11/21) with ventriculoatrial conduction versus 57.6% (19/33) in ventriculoatrial dissociate patients (P = 0.3). Mean of ventriculoatrial Wenchebach point (VAWP) was 400  96.6 and 393  103.6 ms in ventricular tachycardia inducible and non inducible patients respectively (P = 0.4). Presence of ischemic heart disease and lower left ventricular ejection fraction (LVEF) were associated with increased probability of ventricular tachycardia induction (P = 0.008 and 0.04 respectively). Presence of ischemic heart disease predicts ventricular tachycardia inducibility independently. Patients with inducible ventricular tachycardia had slightly shorter atrial-His (AH) interval (97.33  30.4 and 112.1  42.6 ms, P = 0.07).Conclusion: Ventricular tachycardia induction was very slightly more common in ventriculoatrial dissociate patients but we could not prove it. Presence of ischemic heart disease independently and lower left ventricular ejection fraction dependently could predict ventricular tachycardia inducibility.

Keywords

References

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Journal of Isfahan Medical School
Volume 28, Issue 113 - Serial Number 113
September and October 2011
Pages 725-733

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History

  • Receive Date: 29 December 2010
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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