RESUMO
PURPOSE: To assess the relationship between late potentials and spontaneous ventricular arrhythmias, organic heart disease, inducibility of arrhythmias at electrophysiological study and ejection fraction. METHODS: The population is comprised by 52 patients (41 men, 11 women with mean age 50 +/- 16 years) with spontaneous clinically documented ventricular tachycardia or ventricular fibrillation. An electrophysiological study was performed with conventional programmed stimulation. Within a week of the test a study of late potentials was also performed. RESULTS: Late potentials were documented in 73% of the patients with ventricular tachycardia and only in 17% of the patients with ventricular fibrillation. Sixty-eight percent of the patients with ischemic cardiopathy presented late potentials and in these, ventricular tachycardia was inducible in 93%. Only one from a group of 7 patients with ventricular arrhythmias and no organic heart disease, presented late potentials. In patients with late potentials, 84% have inducible ventricular tachycardia, but only 26% of patients without late potentials have inducible ventricular tachycardia. The incidence of late potentials was inversely correlated with left ventricular ejection fraction. CONCLUSION: The presence of late potentials was more frequent in patients with ventricular tachycardia than in patients with ventricular fibrillation. The presence of late potentials has a sensibility of 81.5% and a specificity of 78% to detect patients with inducible ventricular tachycardia.
Assuntos
Eletrofisiologia , Taquicardia Ventricular/fisiopatologia , Fibrilação Ventricular/fisiopatologia , Potenciais de Ação , Adulto , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Volume Sistólico/fisiologia , Taquicardia Ventricular/diagnóstico , Fibrilação Ventricular/diagnósticoRESUMO
Syncope or near-syncope can be the manifestation of a benign problem or a symptom of a life-threatening disease. Vasovagal syncope accounting for almost 70 per cent of cases. We identified 5 young patients who were presented to us with syncope or near-syncope. Diagnostic test, such as electrocardiogram, Holter monitoring and electrophysiological study identified only markers of hypervagotonia. We treated them with oral propantheline. By the time of follow up (20 months) none had recurrent episodes of syncope. Propantheline can be useful in patients with symptomatic vagotonia.