Ventricular tachycardias in individuals with apparently normal heart

  • E. Aliot
  • B. Brembilla-Perrot
  • K. Khalife
  • A. Terrier De La Chaise
  • M. Bianchi
  • J. M. Gilgenkrantz
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 71)


Ventricular tachycardia (VT) is usually associated with heart disease. However, it may occur without clinically evident cardiac abnormalities, and, in this case, the benign character of this arrhythmia has been stressed, compared to VT associated with heart disease. Although clinically well known [1, 2] its pathophysiology is still not well defined. In this chapter, we’ll envisage the clinical pattern of this particular kind of VT.


Ventricular Tachycardia Left Bundle Branch Block Mitral Valve Prolapse Right Bundle Branch Block Sustained Ventricular Tachycardia 
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  1. 1.
    Clarke JM, Hamer J, Shelton JR, Taylor S, Venning GR. 1976. The rhythm of the normal human heart. Lancet 2: 508–522.CrossRefGoogle Scholar
  2. 2.
    Sebastien P, Waynberger M, Beaufils P, Motte G, Slama R, Bouvrain Y. 1976. Les tachycardies ventriculaires isolées sans cardiopathie patente. Arch Mal Coeur 69: 919–928.PubMedGoogle Scholar
  3. 3.
    Bethge KP, Bethge D, Meiners G, Lichtlen PR. 1983. Incidence and prognostic significance of ventricular arrhythmias in individuals without detectable heart disease. Eur Heart J 4: 338–346.PubMedGoogle Scholar
  4. 4.
    Bjerregard P. 1982. Premature beats in healthy subjects 40–79 years of age. Eur Heart J 3: 493–503.Google Scholar
  5. 5.
    Brodsky M, Wu D, Denes P, Kanakis C, Rosen K. 1977. Arrhythmias documented by 24 hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease. Am J Cardiol 39: 390–395.PubMedCrossRefGoogle Scholar
  6. 6.
    Fleg JL, Lakatta EG. 1984. Prevalence and prognosis of exercise induced non sustained ventricular tachycardia in apparently healthy volunteers. Am J Cardiol 54: 762–764.PubMedCrossRefGoogle Scholar
  7. 7.
    Kostis JB, Mc Crone K, Moreyra AE, Gotzoyannis S, Aglitz N, Natarajan N, Kuo PT. 1981. Premature ventricular complexes in the absence of identifiable heart disease. Circulation 63: 1351–1355.PubMedCrossRefGoogle Scholar
  8. 8.
    Montague TJ, Mc Pherson D, Mc Kenzie BR, Spencer CA, Nanton MA, Horacek BM. 1983. Frequent ventricular ectopic activity without underlying cardiac disease: analysis of 45 subjects. Am J Cardiol 52: 980–984.PubMedCrossRefGoogle Scholar
  9. 9.
    Buxton AE, Waxman HL, Marchlinski FE, Josephson ME. 1983. Electrophysiologic studies in non sustained ventricular tachycardia: relation to underlying heart disease. Am J Cardiol 52: 985–991.PubMedCrossRefGoogle Scholar
  10. 10.
    Slama R, Leclercq JF, Coumel P. 1985. Paroxysmal ventricular tachycardia in patients with apparently normal heart. In: Cardiac electrophysiology and arrhythmias, D.P. Zipes and J. Jalife Ed., Grune and Stratton, Orlando: 545–552.Google Scholar
  11. 11.
    Froment R, Gallavardin L, Cahen P. 1953. Paroxysmal ventricular tachycardia. A clinical classification. Br Heart J 15: 172–178.PubMedCrossRefGoogle Scholar
  12. 12.
    Prystowsky EN, Zipes DP. 1984. Electrophysiologic testing in ventricular tachycardia. In: Tachycardias, B. Sorawicz, C. Pratap Reddy, E.N. Prystowsky Ed., Martinus Nijhoff Publishers, Boston: 293–309.CrossRefGoogle Scholar
  13. 13.
    Naccarelli GV, Prystowsky EN, Jackman WM, Heger JJ, Rahilly GT, Zipes DP. 1982. Role of electrophysiologic testing in managing patients who have ventricular tachycardia unrelated to coronary artery disease. Am J Cardiol 50: 165–171.PubMedCrossRefGoogle Scholar
  14. 14.
    Rahilly GT, Prystowsky EN, Zipes DP, Naccarelli GV, Jackman WM, Heger JJ. 1982. Clinical and electrophysiologic findings in patients with repetitive monomorphic ventricular tachycardia and otherwise normal electrocardiogram. Am J Cardiol 50: 459–468.PubMedCrossRefGoogle Scholar
  15. 15.
    Chapman JH, Schank JP, Crampton RS. 1975. Idiopathic ventricular tachycardia: an intracardiac electrical, hemodynamic and angiographic assessment of six patients. Am J Med 59: 470–480.PubMedCrossRefGoogle Scholar
  16. 16.
    Veltri EP, Platia EV, Giffith LVC, Reid PR. 1985. Programmed electrical stimulation and long term follow up in asymptomatic NSVT. Am J Cardiol 56: 309–314.PubMedCrossRefGoogle Scholar
  17. 17.
    Fulton DR, Chung KJ, Tabakin BS, Keane JF. 1985. Ventricular tachycardia in children without heart disease. Am J Cardiol 55: 1328–1331.PubMedCrossRefGoogle Scholar
  18. 18.
    Fauchier JP, Cosmay P, Desveaux B. 1984. Troubles du rhythme ventriculaire du sujet sain sans cardiopathie apparente. Info Cardiol 8: 747–770.Google Scholar
  19. 19.
    Garson A Jr. 1987. Ventricular arrhythmias in the young. Clinical and experimental findings. In: Ventricular Tachycardias, from Mechanism to Therapy, E. Aliot and R. Lazzara Ed., Martinus Nijhoff Publishers, Dordrecht.Google Scholar
  20. 20.
    Coumel P, Leclercq JF, Attuel P, Rosengarten M, Milosevic D, Slama R, Bouvrain Y. 1980. Tachycardies ventriculaires en salves. Etudes electrophysiologique et thérapeutique. Arch Mal Coeur 73: 153–164.PubMedGoogle Scholar
  21. 21.
    Coumel P, Leclercq JF, Slama R. 1985. Repetitive monomorphic idiopathic ventricula tachycardia. In: Cardiac electrophysiology and arrhythmias, D.P. Zipes and J. Jalife Ed., Grune and Stratton, Orlando: 457–468.Google Scholar
  22. 22.
    Pietras RJ, Lam W, Bauernfiend R, Sheikh A, Palileo E, Strasberg B, Swiryn S, Rosen KM. 1983. Chronic recurrent right ventricular tachycardia in patients without ischemic heart disease: clinical, hemodynamic and angiographic findings. Am Heart J 105: 357–366.PubMedCrossRefGoogle Scholar
  23. 23.
    Buxton AE, Waxman HL, Marchlinski FE, Simson MB, Cassidy DM, Josephson ME. 1983. Right ventricular tachycardia: clinical and electrophysiologic characteristics. Circulation 68: 917–927.PubMedCrossRefGoogle Scholar
  24. 24.
    Buxton AE, Marchlinski FE, Doherty JV, Cassidy DM, Vassallo JA, Flores BT, Josephson ME. 1984. Repetitive monomorphic ventricular tachycardia: clinical and electrophysiologic characteristics in patients with and patients without organic heart disease. Am J Cardiol 54: 997–1002.PubMedCrossRefGoogle Scholar
  25. 25.
    Zimmermann M, Maison Blanche P, Cauchemez B, Leclercq JF, Coumel P. 1986. Determinants of the spontaneous ectopic activity in repetitive monomorphic idiopathic ventricular tachycardia. J Am Coll Cardiol 7: 1219–1227.PubMedCrossRefGoogle Scholar
  26. 26.
    Gallavardin L. 1922. Extrasystolie ventriculaire à paroxysmes tachycardiques prolongés. Arch Mal Coeur 15: 298–306.Google Scholar
  27. 27.
    Parkinson J, Papp C. 1947. Repetitive paroxysmal tachycardia. Br Heart J 9: 241–262.CrossRefGoogle Scholar
  28. 28.
    Dimond EG, Hayes HL. 1960. Benign paroxysmal ventricular tachycardia: report of a case. Ann Intern Med 53:1255–1260.Google Scholar
  29. 29.
    Denes P, Wu D, Dhingra RG. 1976. Electrophysiologic studies in patients with chronic recurrent ventricular tachycardia. Circulation 54: 229–236.PubMedGoogle Scholar
  30. 30.
    Palileo EV, Ashley WW, Swiryns S, Bauernfiend RA, Strasberg B, Petropoulos AT, Rosen KM. 1982. Exercise provocable right ventricular out flow tract tachycardia. Am Heart J 104:185–193.PubMedCrossRefGoogle Scholar
  31. 31.
    Belhassen B, Shapira I, Pelleg A, Copperman I, Kauli N, Laniado S. 1984. Idiopathic recurrent sustained ventricular tachycardia responsive to Verapamil: an ECG electrophysiologic entity. Am Heart J 108: 1034–1036.PubMedCrossRefGoogle Scholar
  32. 32.
    German LDG, Packer DL, Bardy GH, Gallagher JJ. 1983. Ventricular tachycardia induced by atrial stimulation in patients without symptomatic cardiac disease. Am J Cardiol 52: 1202–1207.PubMedCrossRefGoogle Scholar
  33. 33.
    Lin FC, Finley CD, Rahimtoola SH, Wu D. 1983. Idiopathic paroxysmal ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation: a unique clinical entity with specific properties. Am J Cardiol 52: 95–100.PubMedCrossRefGoogle Scholar
  34. 34.
    Klein GS, Millman J, Yee R. 1984. Recurrent ventricular tachycardia responsive to Verapamil. P.A.C.E. 7: 938–948.Google Scholar
  35. 35.
    Fauchier JP, Desveaux B, Cosnay P, Raynaud P, Philippe L, Itti R. 1985. Troubles du rhythme ventriculaire complexes du sujet jeune. Arch Mal Coeur 9: 1333–1343.Google Scholar
  36. 36.
    Josephson ME, Horowitz LN, Farshidi A, Spielman SR, Michelson EL, Greenspan AM. 1979. Recurrent sustained ventricular tachycardia. E. Pleomorphism. Circulation 59: 459–468.PubMedGoogle Scholar
  37. 37.
    Coumel P, Leclercq JF, Attuel P, Maison Blanche P. 1984. The QRS morphology in post myocardial infarction ventricular tachycardia. A study of 100 tracings compared with 70 cases of idiopathic ventricular tachycardia. Eur J Cardiol 5: 792–805.Google Scholar
  38. 38.
    Rosenbaum MB. 1969. Classification of ventricular extrasystoles according to form. J Electrocardiology 2: 289–298.CrossRefGoogle Scholar
  39. 39.
    Vetter V, Josephson ME, Horowitz L. 1981. Idiopathic sustained ventricular tachycardia in children and adolescents. Am J Cardiol 47: 315–322.PubMedCrossRefGoogle Scholar
  40. 40.
    Wu D, Kou HC, Hung JS. 1981. Exercise triggered paroxysmal ventricular tachycardia: a repetitive rhythmic activity possibly related to after depolarisation. Ann Int Med 95: 410–414.PubMedGoogle Scholar
  41. 41.
    Breithardt G, Becker R, Seipel L, Abenroth RR, Ostermeyer J. 1981. Non invasive detection of late potentials in man: a new marker for ventricular tachycardia. Eur Heart J 2: 1–11.PubMedGoogle Scholar
  42. 42.
    Simson MB. 1981. Identification of patients with ventricular tachycardia after myocardial infarction from signals in the terminal QRS complex. Circulation 64: 235–242.PubMedCrossRefGoogle Scholar
  43. 43.
    Berbari EJ, Scherlag BJ, Hope RR, Lazzara R. 1978. Recording from the body surface of arrhythmogenic ventricular activity during the ST segment. Am J Cardiol 41: 697–702.PubMedCrossRefGoogle Scholar
  44. 44.
    Buxton AE, Simson MB, Falcone R, Dresden C, Marchlinski FE, Waxman HL, Josephson ME. 1984. Signal averaged ECG in patients with nonsustained ventricular tachycardia: identification of patients with potential for sustained ventricular arrhythmias. J Am Coll Cardiol 3: 495 (abstract).Google Scholar
  45. 45.
    Brugada P, Wellens HJJ. 1984. Programmed electrical stimulation of the human heart. In: Tachycardias, Mechanisms, Diagnosis, Treatment, M.E. Josephson and H.J.J. Wellens Ed., Lea and Febiger, Philadelphia, p. 61–89.Google Scholar
  46. 46.
    Terrier de la Chaise A, Brembilla-Perrot B, Balaud A, Morizot P, Cherrier F, Pernot C. 1987. Correlation potentiels tardifs de surface et arythmies ventriculaires déclenchables (à propos de 115 cas). Arch Mal Coeur 80: 177–183.PubMedGoogle Scholar
  47. 47.
    Perrot B, Thiel B, Cherrier F, Faivre G. 1984. Résultats de l’application systématique des méthodes de stimulation ventriculaire. Arch Mal Coeur 3: 262–272.Google Scholar
  48. 48.
    Brembilla-Perrot B, Terrier de la Chaise A, Pichene M, Pernot C, Cherrier F. 1986. Valeur diagnostique du test à l’Isuprel dans les tachycardies d’effort. Arch Mal Coeur 3: 309–313.Google Scholar
  49. 49.
    Sugrue DD, Holmes DR, Gersh BJ, Edwards WD, Me Laran CJ, Wood DL, Osborn MJ, Hammil SL. 1984. Cardiac histologie findings in patients with life threatening ventricular arrhythmias of unknown origin. J Am Coll Cardiol 4: 952–957.PubMedCrossRefGoogle Scholar
  50. 50.
    Wellens JJ. 1978. Value and limitation of programmed electrical stimulation of the heart in the study and treatment of tachycardias. Circulation 57: 845–853.PubMedGoogle Scholar
  51. 51.
    Touboul P, Claveyrolas R, Huerta F, Porte J, Delahaye JP. 1975. Tachycardie ventriculaire induite par des battements supraventriculaires prématurés à complexe QRS normal. Arch Mal Coeur 68: 969–976.PubMedGoogle Scholar
  52. 52.
    Zipes DP, Foster PR, Troup PJ, Pederson D. 1978. Atrial induction of ventricular tachycardia reentry versus triggered automaticity. Am J Cardiol 44:1–8.CrossRefGoogle Scholar
  53. 53.
    Wellens HJJ, Bar FW, Farre J, Ross DL, Weiner I, Vanagt EJ. 1980. Initiation and termination of ventricular tachycardia by supraventricular stimuli. Am J Cardiol 46: 576–582.PubMedCrossRefGoogle Scholar
  54. 54.
    Cranefield PF. 1977. Action potentials, after potentials and arrhythmias. Circ Res 41: 415–423.PubMedGoogle Scholar
  55. 55.
    Yeh BK, Lazzara R. 1977. Genesis of triggered and spontaneous automaticity by norepinephrine and isoproterenol in ventricular myocardium. Fed Proc 36:1660–1668.Google Scholar
  56. 56.
    Leclercq JF, Rosengarten MD, Attuel P, Coumel P, Slama R. 1981. L’extrasystolie ventriculaire idiopathique: une parasystolic ventriculaire droite non protégée du rhythme sinusal. Arch Mal Coeur 74: 1249–1261.PubMedGoogle Scholar
  57. 57.
    Fontaine G, Guiraudon G, Frank R, Vedel J, Grosgogeat Y, Cabrol C, Facquet J. 1977. Stimulation studies and epicardial mapping in ventricular tachycardia: study of mechanisms and selection for surgery. In: Reentrant arrhythmias, H.E Kulbertus Ed., M.T.P. Publishers: Lancaster: 334–350.Google Scholar
  58. 58.
    Marcus FI, Fontaine G, Guiraudon G, Frank R, Laurenceau JL, Malergue MC, Grosgogeat Y. 1982. Right ventricular dysplasia: a report of 24 cases. Circulation 65: 384–399.PubMedCrossRefGoogle Scholar
  59. 59.
    Pietras RJ, Mautner R, Denes P, Wu D, Dhingra R, Towne W, Rosen KM. 1977. Chronic recurrent right and left ventricular tachycardia: comparison of clinical and angiographic findings. Am J Cardiol 40: 32–37.PubMedCrossRefGoogle Scholar
  60. 60.
    Kennedy HL, Pescarmona JE, Bouchard RJ, Goldberg RJ, Caralis DG. 1982. Objective evidence of occult myocardial dysfunction in patients with frequent ventricular ectopy without clinically apparent heart disease. Am Heart J 104: 57–65.PubMedCrossRefGoogle Scholar
  61. 61.
    Morgera T, Salvi A, Alberti E, Silvestri F, Camerini F. Morphological findings in apparently idiopathic ventricular tachycardia. An echocardiographic haemodynamic and histologic study. Eur Heart 6: 323–334.Google Scholar
  62. 62.
    Vignola PA, Aonuma K, Swaye PS, Rozanski JJ, Blanstein RL, Benson J, Gosselin AJ, Lister JW. 1984. Clinically silent myocarditis and ventricular tachycardia. Circulation 70 (II): 403 (abstract).Google Scholar
  63. 63.
    Strain JE, Grose RM, Factor SM, Fisher ID. 1983. Result of endomyocardial biopsy in patients with spontaneous ventricular tachycrdia but without apparent structural heart disease. Circulation 68: 1171–1181.PubMedCrossRefGoogle Scholar
  64. 64.
    Van Hoogenhuyze D, Olsen E, Crook B, Van de Brand M. 1981. Myocardial biopsy in patients with ventricular tachycardia. Am J Cardiol 47: 499 (abstract).CrossRefGoogle Scholar
  65. 65.
    Dungan WT, Garson A Jr, Gillette PC. 1981. Arrhythmogenic right ventricular dysplasia: a cause of ventricular tachycardia in children with apparently normal hearts. Am Heart J 102: 745–750.PubMedCrossRefGoogle Scholar
  66. 66.
    James TN, Marilley RJ, Marriot HJL. 1975. De subitaneis mortibus. XI. Young girl with palpitations. Circulation 51: 743–748.PubMedGoogle Scholar
  67. 67.
    Kennedy HL, Whitlock JA, Sprague M, Kennedy LJ Buckingham TA, Golberg RJ. 1985. Long term follow-up of asymptomatic healthy subjects with frequent and complex ventricular ectopy. N Engl J Med 312: 193–197.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, Dordrecht 1987

Authors and Affiliations

  • E. Aliot
    • 1
  • B. Brembilla-Perrot
    • 1
  • K. Khalife
    • 1
  • A. Terrier De La Chaise
    • 1
  • M. Bianchi
    • 1
  • J. M. Gilgenkrantz
    • 1
  1. 1.Département de CardiologieC.H.R. U. de Nancy, Hôpital CentralNancy CedexFrance

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