Paroxysmal ventricular tachycardia

Paroxysmal ventricular tachycardia; a study of 107 cases

A review is presented of 107 cases of paroxysmal ventricular tachycardia. In the majority it was associated with acute coronary thrombosis or coronary sclerosis, in some with rheumatic valvular disease, and in others with no organic heart disease. It is generally critical and demands careful attention. Occasional cases are overlooked because only one heart sound is present for each cardiac cycle and the heart rate is misjudged to be one-half the actual rate. The outlook often is serious if the condition is not effectively treated. Therapy generally is successful in controlling the arrhythmia. The most valuable drug is quinidine. Other medications are magnesium sulfate, atropine, potassium salts, and possibly morphine.

Ventricular tachycardia: historical perspective

Ventricular tachycardia is now diagnosed frequently in patients with organic heart disease. Although ventricular tachycardia was first demonstrated electrocardiographically 75 years ago, the natural history, fundamental mechanisms, and optimal management have remained elusive. Early observers commented on the rarity of occurrence and poor prognosis associated with this arrhythmia, yet with time, some patients with ventricular tachycardia were reported to survive for prolonged periods. Because of the sporadic nature of the arrhythmia and its variable prognosis, assessment of the efficacy of therapies has been difficult. A wide variety of treatments has been advocated with enthusiasm, but only a few have been consistently reported to be effective. Citation of historical data to claim benefit from new treatments should be viewed with caution.