Noninvasive clues for diagnosing ventricular tachycardia mechanism

J Electrocardiol. 2018 Mar-Apr;51(2):163-169. doi: 10.1016/j.jelectrocard.2017.11.009. Epub 2017 Nov 21.

Abstract

The electrophysiologic mechanisms responsible for the initiation and maintenance of ventricular tachycardia (VT) include enhanced automaticity, triggered activity and reentry. Differentiating between these three mechanisms can be challenging for the clinician and usually requires an invasive electrophysiology study. Establishing the underlying VT mechanism in a particular patient is helpful to define the optimal therapeutic approach, including the selection of pharmacologic agents or delineation of an ablation strategy. The purpose of this review is to provide insight into the possible VT mechanisms based on noninvasive clues from the clinical history, 12-lead electrocardiogram, tachycardia onset and termination and the response to pharmacologic manipulation.

Keywords: Abnormal automaticity; Electrocardiography; Reentry; Triggered activity; Ventricular tachycardia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use*
  • Diagnosis, Differential
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac*
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Tachycardia, Ventricular / diagnosis*
  • Tachycardia, Ventricular / physiopathology*

Substances

  • Anti-Arrhythmia Agents