Evaluation of the Severity of Ventricular Rhythm Disturbances: Value of Electrophysiological Testing and Recording of Late Potentials
Sudden death is one of the major risks in patients suffering from coronary heart disease especially after myocardial infarction. In most instances this final event is caused by ventricular tachyarrhythmias. Many studies have shown that ventricular premature beats are the harbingers of sudden death in these patients . The prerequisite for the induction of ventricular tachyarrhythmias is the arrhythmogenic electrophysiological substrate. The presence of an arrhythmogenic substrate is, however, not sufficient to develop ventricular tachycardia. Instead, some additional factors (such as ventricular premature beats) are necessary to initiate a reentrant tachycardia. Ventricular premature beats can be recorded by Holter monitoring and exercise tests. However, they have been shown to have a low predictive value for sudden death [2, 3]. The presence or absence of an arrhythmogenic substrate can be assessed by means of programmed stimulation (ventricular “vulnerability”). Of course, the fibrillation threshold cannot be measured in man. However, in experimental studies a good correlation between the fibrillation threshold and repetitive ventricular responses was found .
KeywordsRadionuclide Cardiomyopathy Cardiol Hunt Dial
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