Paroxysmal Ventricular Tachycardia in the Absence of Organic Heart Disease

Abstract

Recurrent paroxysms of ventricular tachycardia in a young woman with no other evidence of heart disease could be precipitated by slowing the sinus rate and abolished by speeding the sinus rate. Between paroxysms, she has frequent premature ventricular contractions and periods of bigeminal rhythm. The paroxysms of tachycardia were usually well tolerated causing only anxiety; but at times, they resulted in total circulatory collapse with syncope and seizure activity. Most cases of paroxysmal ventricular tachycardia without heart disease reported in the literature followed courses very similar to this patient. Though sudden death was reported in several cases, a good outcome was more common, with the cessation of the paroxysms after a period of months or years. A small group of patients were reported to have episodes of sustained ventricular tachycardia without premature contractions between the episodes. Syncope and sudden death were not reported in this group; though heart failure did result after a prolonged episode of tachycardia.