Characteristics such as ventricular tachycardia pirouette. Pleomorphism of ventricular tachycardia

These are typical characteristics of ventricular tachycardia type of pirouette observed when it occurs in patients with prolongation of the interval Q-T, usually as a result of changes in metabolism (hypoxemia, hypokalemia, etc.) or losle administration of various drugs (quinidine, prenylamine liters etc ..) However, there are an increasing number of patients with ventricular tachycardia and complex configuration of the QRS, typical of "pirouette" who have heart disease, the coronary patients who often lack a long Q-T interval (up to 70% in some studies), a long interval coupling, a slow basic rhythm, metabolic or electrolyte changes or effects associated with taking anti-arrhythmic drugs. For this reason, all characteristics, except for the configuration of the complex QRS, characteristic polymorphic ventricular tachycardia, similar to those of classical monomorphic ventricular tachycardia, in which she transformed.

Thus, it can be assumed on the basis of clinical data and results of treatment, this subgroup of polymorphic ventricular tachycardia (the configuration of the complex QRS, indicating a "pirouette" and the rest electrocardiographic features - a classic ventricular tachycardia) is a variant of the classical ventricular tachycardia, and ventricular not an option tachycardia type "pirouette."

It is necessary to distinguish tachycardia type "pirouette" mainly from ventricular fibrillation. "Pirouette" is a typical configuration, and a slower rate than ventricular fibrillation, it responds to stimulation of the heart and is usually self-limiting. As was described, the configuration of the QRS complex is identical to that observed in ventricular tachycardia of the "pirouette", but without additional traits, such cases must be regarded as a classic of ventricular tachycardia and ventricular tachycardia is not a type of "pirouette."

Characteristics such as ventricular tachycardia pirouette. Pleomorphism of ventricular tachycardia

Ventricular tachycardia of "pirouette" is a severe arrhythmia, which can sometimes lead to ventricular fibrillation, and is often the cause of sudden death among ambulatory patients (15%), according to Leclerq and Coumel, as a result of the introduction of certain medications or electrolyte imbalance, often no signs of apparent heart disease.

Other types (pleomorphism). Completely block the picture ha near the right and left bundle branch block alternate. Such changes may be sudden or gradual, transient or prolonged, usually accompanied by changes in cycle length. Tachycardia may be uneven, at least for such changes. In any case, the usual duration of a few minutes the ECG may not reveal changes in the regular, rhythm. In this case it is impossible to identify the differences between classical monomorphic ventricular tachycardia, tachycardia, and this: why it is appropriate to recall that one can be mistaken for areas of tachycardia, relying only on the configuration. Using Holter monitoring confirmed that the volleys of ventricular tachycardia are sometimes polymorphic.

Other types of polymorphic ventricular tachycardia have also been described, although in most cases they represent variants of tachycardia type "pirouette" or specific morphological changes, which are based on mechanisms similar to those that were described earlier. Some classical ventricular tachycardia with frequent seizures or drainage complexes of the ECG may show different pictures, though rarely observed (see above). Finally, if ventricular tachycardia is converted to ventricular fibrillation, it may have an atypical configuration.