Idioventricular tachycardia in acute MI occurs early, can exceed 100 beats/min, and does not require preceding sinus bradycardia, highlighting the need to distinguish it from extrasystolic ventricular tachycardia.
Alerts clinicians to early idioventricular tachycardia at rates >100/min in acute MI; leaves open differentiation from ventricular tachycardia in larger cohorts.
An analysis is presented of 28 cases in a coronary care unit in which idioventricular tachycardia developed. In all instances this arrhythmia developed within the first few hours after the onset of chest pain. None of the patients showed this arrhythmia after the first 36 hours. Patients with both anterior and inferior myocardial infarctions showed this arrhythmia with almost equal frequency. In contradistinction to most reports, in over 30% of the cases the ventricular rate exceeded 100/min during an episode of idioventricular tachycardia. Sinus bradycardia was not a prerequisite for the development of this arrhythmia. The differentiation of idioventricular tachycardia from extrasystolic ventricular tachycardia is discussed, and the need to distinguish these two ventricular dysrhythmias from the prognostic and therapeutic standpoints is stressed.
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Vohra et al. (1971) studied this question.
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