Clinical and electrophysiologic features of idiopathic left ventricular aneurysm with sustained ventricular tachycardia

We examined 10 patients with idiopathic left ventricular (LV) aneurysm with sustained ventricular tachycardia (VT) (Id-An group), and compared them wi th those in 16 age- and sex-matched patients who had postinfarction aneurys m and VT (MI-An group) to clarify detailed clinical and electrophysiologic characteristics of idiopathic LV aneurysm. The clinical and laboratory data and results of electrocardiography, electrophysiologic, and morphologic ex aminations in the two groups were compared. In the Id-An group, the LV aneu rysms were located mon often at the posterior and/or inferior wall, while i n the MI-An group, they were more often located at the anterior and/or apic al wall (P<0.001). The LV end-diastolic volume index was significantly smal ler and the LV ejection fraction was significantly higher in the Id-An grou p (P<0.001). The size of the aneurysm and the area with abnormal electrogra ms in the Id-An group were significantly smaller than those in the MI-An gr oup (P<0.005 and P<0.001, respectively). The inducibility of VT was high in both groups, and ventricular pacing during VT showed entrainment phenomeno n in most of the patients. Thus, in both groups, the abnormal electrograms were closely associated with the wall motion abnormality, and reentry was s uggested as the mechanism of VT. In the Id-An group, since the lesions were anatomically and electrophysiologically confined to the posterior and/or i nferior wall, the global LV function was more well preserved compared with the MI-An group. (C) 1998 Published by Elsevier Science Ireland Ltd. All ri ghts reserved.