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Multiform Ventricular Ectopic Rhythm by Combined Parasystolic and Reentrant Activities
Author(s) -
LOPERFIDO FRANCESCO,
ANSALONE GERARDO,
SANTARELLI PIETRO,
BELLOCCI FULVIO
Publication year - 1984
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1984.tb05590.x
Subject(s) - medicine , reentry , cardiology , sinus rhythm , rhythm , bigeminy , ventricular tachycardia , atrial fibrillation
Multiform ventricular ectopic rhythm (MVER), i.e., at least two QRS configurations of ventricular ectopic beats (VEBs), was assessed by 24‐hour ambulatory ECG recording in four patients with ventricular parasystole (VP). In two of these four patients, VEBs with fixed coupling to the preceding impulses coexisted with VP beats of different configuration. In case no. 1, the VEBs had an identical coupling interval to sinus bents and VP beats, suggesting a mechanism of reentry elicited from both dominant pacemakers. In case no. 2, an intermittent form of VP due to type II second‐degree entrance block was present. In this patient, the VEBs were coupled to sinus beats and to sinus‐VP fusion beats and appeared to be dependent on the sinus beats reaching the VP focus. A mechanism of reentry determined by the penetration of sinus beats into the VP area, with prematurity‐dependent aberrancy of VEBs, was suggested for the coupled VEBs in this patient. These observations suggest that the coexistence of an automatic ventricular ectopic focus and of a reentrant activity determined by, or elicited from, an area of automaticity may constitute the underlying mechanism of MVER in some patients.