Ventricular premature depolarizations triggered by incremental dose isoproterenol infusion: common electrocardiographic features.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Nuria RivasF E Marchlinski

Abstract

To identify the prevalence of adrenergically mediated ventricular premature depolarizations (VPDs) and characterize their electrocardiographic (ECG) features and specific anatomically determined sites of origin within the ventricles. VPDs occurring during incremental isoproterenol infusion (3 to 20 mug/min) in 108 patients (30 women, mean age 58 +/- 10 years) with normal ventricular function and no previous ventricular tachycardia (VT) were identified. VPDs were grouped to a probable anatomic region of origin based on 12-lead ECG. The 235 VPD morphologies (median 2 per patient, range 1-13) were observed in 85/108 (79%) patients. The most frequent regions of origin were: peri-mitral annulus 17%, left-Purkinje network 14%, right ventricle (RV) outflow tract 14%, apical RV free wall 11% and peri-tricuspid annulus 10%. Only 39 (17%) VPDs were not easily classified. Adrenergically mediated VPDs are frequent in patients without structural heart disease or VT and tend to originate from a few anatomic sites.

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Citations

Nov 23, 2019·JACC. Clinical Electrophysiology·Francis MarchlinskiMaciej Kubala

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