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J Cardiovasc Med (Hagerstown). 2013 Nov;14(11):791-8. doi: 10.2459/JCM.0b013e32835ef0b6.

Clinical spectrum of fascicular tachycardia.

Author information

  • 1aStruttura Complessa di Cardiologia, Dip. Emergenza, ASS n2 Isontina, Ospedale di Monfalcone, Monfalcone bCentro Cardiovascolare, ASS n1 Triestina, Trieste cStruttura Complessa di Cardiologia, Dip. Cardio-Toracico, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, Udine dStruttura Complessa di Cardiologia, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Trieste, Trieste, Italy.

Abstract

AIMS:

Ventricular tachycardia spreading from the anterior or posterior division of the left bundle branch is generally called fascicular tachycardia (FT). We will present our experience with FT, a type of ventricular tachycardia not necessarily implying the absence of heart disease and/or sensitivity to selective antiarrhythmic drugs, but only particular routes of left ventricular depolarization.

METHODS:

Since 1981 we have had the opportunity to study 10 cases of FT (nine men and one woman; aged 28-77 years, mean ± SD 55 ± 18.6 years) by means of echocardiography, coronary angiography (seven cases), endomyocardial biopsy (five cases), signal-averaged electrocardiogram (SAECG, nine patients), electrophysiological and electropharmacological evaluation.

RESULTS:

Seven patients had paroxystic, extrastimulus inducible FT that was sensitive to verapamil given intravenously (group A); three patients, on the other hand, showed repetitive or incessant FT, not modifiable by stimulation techniques and sensitive to class 1 antiarrhythmic drugs (group B). Patients presented histologic substrates ranging from the absence of heart disease to previous myocardial infarction or myocarditis. FT spontaneously disappeared within 2 years in group B, while frequently persisted in the long term in group A.

CONCLUSIONS:

FT is not a homogeneous group of ventricular tachycardia, as patients may differ according to clinical presentation, mechanisms that are involved in the genesis of the arrhythmia and natural history; the histologic substrate is highly variable, ranging from the total absence of heart disease to severe forms of myocardial involvement.

PMID:
23442810
[PubMed - indexed for MEDLINE]
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