Malignant Form of Idiopathic Ventricular Arrhythmia Originating from the Right Ventricular Outflow Tract

概要

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Background: Idiopathic ventricular fibrillation (VF) and/or polymorphic VT are occasionally initiated by VT or premature ventricular contraction (PVC) originating from the RVOT. Methods: Among 56 patients without structural heart disease in whom EPS was conducted for idiopathic VT arising from the RVOT, we examined the clinical characteristics in 5 patients with VF or polymorphic VT initiated by PVC originating from RVOT. Results: Episodes of VF were documented in 1 patient and polymorphic VT in 4 patients including one with a family history of aborted sudden death. In holter recording, there was no PVC/VT with short coupling interval in any patients. In Treadmill test, there were no patient with VT/VF inducted by exercise. 2 patients had J waves. The morphologies of PVC triggering polymorphic VT or VF were various: QS pattern was seen in the lead I in 3 patients, RS pattern was seen in the remaining. Conclusion: In this study, we found that the lack of inducibility by exercise and the absence of family history of cardiac disease were not always benign factor in the RVOT-VT/PVC. There were not any special feature in the form of PVC triggering VT/VF. Our findings may be useful to treat the patients with history of syncope and episodes of RVOT VT/VPC.