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Repetitive responses to ventricular extrastimuli: incidence, mechanism, and significance
Journal article   Peer reviewed

Repetitive responses to ventricular extrastimuli: incidence, mechanism, and significance

Ardeshir Farshidi, Eric L. Michelson, Allan M. Greenspan, Scott R. Spielman, Leonard N. Horowitz and Mark E. Josephson
The American heart journal, v 100(1)
1980
PMID: 7386366

Abstract

Repetitive ventricular responses (RVR) to programmed ventricular stimulation were observed in 238 of 400 patients (59.5%). Two types of RVR with different mechanisms and clinical significance in relation to ventricular arrhythmias could be identified. 1. 1. Repetitive ventricular responses resulting from bundle branch reentry occurred in 53% of patients without any significant difference of incidence in the presence (52.9%) or absence (54.1%) of organic heart disease. 2. 2. Repetitive ventricular responses resulting from intraventricular reentry occurred in 19.5% of patients with a significantly higher incidence in patients with (23.9%) than without (8.1%) organic heart disease. Thirty-eight of 41 (92.7%) patients with inducible ventricular tachycardia or fibrillation also had intraventricular reentry, but only 9.1% of patients without these arrhythmias manifested intraventricular reentry (p < 0.005). Moreover, the mode of induction and the configuration of intraventricular reentry was closely related to that of ventricular tachycardia when induced. It is concluded that bundle branch and intraventricular reentry are different phenomena, both in mechanism and relationship, to spontaneous ventricular arrhythmias. Bundle branch reentry appears to be a benign phenomenon which represents a physiological response of the His-Purkinje system and is not directly related to ventricular arrhythmias. On the other hand, our data suggest that intraventricular reentry may be a “pathologic” phenomenon closely related to ventricular arrhythmias. The presence of intraventricular reentry may identify patients who are prone to develop ventricular tachycardia or fibrillation.

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Cardiac & Cardiovascular Systems
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