Rapid atrial fibrillation (mean heart rate 153±30 beats/min) acted as a triggering factor for monomorphic ventricular tachycardia in 8 patients with structural heart disease and mean LVEF of 41%.
Observational (n=8)
Does rhythm or rate control therapy prevent the recurrence of monomorphic ventricular tachycardia triggered by rapid atrial fibrillation in patients with structural heart disease?
Rapid atrial fibrillation can act as a triggering factor for monomorphic ventricular tachycardia in patients with structural heart disease, and suppressing AF or controlling its rate may effectively prevent VT recurrence.
Spontaneous degeneration of rapid atrial fibrillation (AF) to ventricular fibrillation has been documented in patients with hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White (WPW) syndrome. However, the importance of rapid AF as a triggering factor leading to sustained ventricular tachycardia (VT) in patients with other structural heart diseases is unknown. The purpose of this study was to characterize patients who developed VT following paroxysmal or chronic AF with a rapid ventricular response. The mode of VT initiation and clinical characteristics were reviewed in 8 patients (7 men, 1 woman; age 64±9 years) with monomorphic VT preceded by rapid AF (6 paroxysmal, 2 chronic). All patients developed monomorphic VT (mean cycle length 285±31 ms) with syncope only after rapid, but hemodynamically stable, AF (mean heart rate 153±30 beats/min) without acute ischemia or exacerbation of heart failure. There was no significant variation in R-R intervals of the AF preceding VT. All patients had structural heart disease other than HCM with a mean left ventricular ejection fraction of 41±12%. During the 807±201 days of follow-up, VTs did not recur in 7 patients. Sinus rhythm was maintained in all patients who received amiodarone. Rapid AF may be an important triggering factor of monomorphic VT in some patients with moderately impaired cardiac function. (Jpn Circ J 2001; 65: 1022 - 1028)
Konagai et al. (Mon,) conducted a observational in Ventricular tachycardia following rapid atrial fibrillation (n=8). Rapid atrial fibrillation was evaluated on Mode of VT initiation and clinical characteristics. Rapid atrial fibrillation (mean heart rate 153±30 beats/min) acted as a triggering factor for monomorphic ventricular tachycardia in 8 patients with structural heart disease and mean LVEF of 41%.