Sd. Pringle et al., SIGNIFICANCE OF VENTRICULAR ARRHYTHMIAS IN SYSTEMIC HYPERTENSION WITHLEFT-VENTRICULAR HYPERTROPHY, The American journal of cardiology, 69(9), 1992, pp. 913-917
Hypertensive patients with the electrocardiographic (ECG) pattern of l
eft ventricular (LV) hypertrophy and strain are at increased risk of s
udden death. It has been suggested that ventricular arrhythmias may be
responsible. The prevalence and significance of ventricular arrhythmi
as was therefore studied in 90 hypertensive patients with LV hypertrop
hy and strain by undertaking 48-hour ambulatory ECG monitoring, ECG si
gnal-averaging and programmed ventricular stimulation. Complex ventric
ular ectopic activity (Lown grade greater-than-or-equal-to 3) was dete
cted in 59 patients (66%). Eleven patients (12%) had episodes of nonsu
stained ventricular tachycardia. There were no sustained arrhythmias e
ither on ambulatory ECG monitoring or induced by programmed ventricula
r stimulation. Only 1 patient had ventricular late potentials recorded
by the signal-averaged electrocardiogram. Therefore, there was little
to suggest an underlying arrhythmogenic substrate in these patients.
In conclusion, whereas ventricular arrhythmias occur often in patients
with LV hypertrophy associated with systemic hypertension, their sign
ificance, if any, remains to be established.