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Hemodynamical consequences and tolerance of sustained ventricular tachycardia

AIMS: Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified. METHODS: Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echo...

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Autores principales: Delasnerie, Hubert, Biendel, Caroline, Elbaz, Meyer, Mandel, Franck, Beneyto, Maxime, Domain, Guillaume, Voglimacci-Stephanopoli, Quentin, Mondoly, Pierre, Delmas, Clement, Bongard, Vanina, Rollin, Anne, Maury, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191287/
https://www.ncbi.nlm.nih.gov/pubmed/37196034
http://dx.doi.org/10.1371/journal.pone.0285802
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author Delasnerie, Hubert
Biendel, Caroline
Elbaz, Meyer
Mandel, Franck
Beneyto, Maxime
Domain, Guillaume
Voglimacci-Stephanopoli, Quentin
Mondoly, Pierre
Delmas, Clement
Bongard, Vanina
Rollin, Anne
Maury, Philippe
author_facet Delasnerie, Hubert
Biendel, Caroline
Elbaz, Meyer
Mandel, Franck
Beneyto, Maxime
Domain, Guillaume
Voglimacci-Stephanopoli, Quentin
Mondoly, Pierre
Delmas, Clement
Bongard, Vanina
Rollin, Anne
Maury, Philippe
author_sort Delasnerie, Hubert
collection PubMed
description AIMS: Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified. METHODS: Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical parameters. RESULTS: 114 VTs from 58 patients were included (median 67 years old, 81% ischemic heart disease, median left ventricular ejection fraction 30%). 61 VTs were untolerated needing immediate termination (54%). VT tolerance was tightly linked to the evolution of IAPs. Faster VT rates (p<0.0001), presence of resynchronization therapy (p = 0.008), previous anterior myocardial infarction (p = 0.009) and more marginally larger baseline QRS duration (p = 0.1) were independently associated with VT tolerance. Only an inferior myocardial infarction was more often present in patients with only tolerated VTs vs patients with only untolerated VTs in multivariate analysis (OR 3.7, 95% CI 1.4–1000, p = 0.03). In patients with both well-tolerated and untolerated VTs, a higher VT rate was the only variable independently associated with untolerated VT (p = 0.02). Two different patterns of hemodynamic profiles during VT could be observed: a regular 1:1 relationship between electrical (QRS) and mechanical (IAP) events or some dissociation between both. VT with the second pattern were more often untolerated compared to the first pattern (78% vs 29%, p<0.0001). CONCLUSION: This study helps to explain the large variability in clinical tolerance during VT, which is clearly related to IAP. VT tolerance may be linked to resynchronization therapy, VT rate, baseline QRS duration and location of myocardial infarction.
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spelling pubmed-101912872023-05-18 Hemodynamical consequences and tolerance of sustained ventricular tachycardia Delasnerie, Hubert Biendel, Caroline Elbaz, Meyer Mandel, Franck Beneyto, Maxime Domain, Guillaume Voglimacci-Stephanopoli, Quentin Mondoly, Pierre Delmas, Clement Bongard, Vanina Rollin, Anne Maury, Philippe PLoS One Research Article AIMS: Factors underlying clinical tolerance and hemodynamic consequences of monomorphic sustained ventricular tachycardia (VT) need to be clarified. METHODS: Intra-arterial pressures (IAP) during VT were collected in patients admitted for VT ablation and correlated to clinical, ECG and baseline echocardiographical parameters. RESULTS: 114 VTs from 58 patients were included (median 67 years old, 81% ischemic heart disease, median left ventricular ejection fraction 30%). 61 VTs were untolerated needing immediate termination (54%). VT tolerance was tightly linked to the evolution of IAPs. Faster VT rates (p<0.0001), presence of resynchronization therapy (p = 0.008), previous anterior myocardial infarction (p = 0.009) and more marginally larger baseline QRS duration (p = 0.1) were independently associated with VT tolerance. Only an inferior myocardial infarction was more often present in patients with only tolerated VTs vs patients with only untolerated VTs in multivariate analysis (OR 3.7, 95% CI 1.4–1000, p = 0.03). In patients with both well-tolerated and untolerated VTs, a higher VT rate was the only variable independently associated with untolerated VT (p = 0.02). Two different patterns of hemodynamic profiles during VT could be observed: a regular 1:1 relationship between electrical (QRS) and mechanical (IAP) events or some dissociation between both. VT with the second pattern were more often untolerated compared to the first pattern (78% vs 29%, p<0.0001). CONCLUSION: This study helps to explain the large variability in clinical tolerance during VT, which is clearly related to IAP. VT tolerance may be linked to resynchronization therapy, VT rate, baseline QRS duration and location of myocardial infarction. Public Library of Science 2023-05-17 /pmc/articles/PMC10191287/ /pubmed/37196034 http://dx.doi.org/10.1371/journal.pone.0285802 Text en © 2023 Delasnerie et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Delasnerie, Hubert
Biendel, Caroline
Elbaz, Meyer
Mandel, Franck
Beneyto, Maxime
Domain, Guillaume
Voglimacci-Stephanopoli, Quentin
Mondoly, Pierre
Delmas, Clement
Bongard, Vanina
Rollin, Anne
Maury, Philippe
Hemodynamical consequences and tolerance of sustained ventricular tachycardia
title Hemodynamical consequences and tolerance of sustained ventricular tachycardia
title_full Hemodynamical consequences and tolerance of sustained ventricular tachycardia
title_fullStr Hemodynamical consequences and tolerance of sustained ventricular tachycardia
title_full_unstemmed Hemodynamical consequences and tolerance of sustained ventricular tachycardia
title_short Hemodynamical consequences and tolerance of sustained ventricular tachycardia
title_sort hemodynamical consequences and tolerance of sustained ventricular tachycardia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10191287/
https://www.ncbi.nlm.nih.gov/pubmed/37196034
http://dx.doi.org/10.1371/journal.pone.0285802
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