INFLUENCE OF RIGHT-VENTRICULAR SITE OF STIMULATION AND INFARCT LOCATION ON THE INDUCIBILITY OF VENTRICULAR-TACHYCARDIA IN PATIENTS WITH CORONARY-ARTERY DISEASE

No prior studies have evaluated the relationship between the site of r ight ventricular stimulation, the site of prior infarction, and the in ducibility of ventricular tachycardia (VT). This study was performed t o determine if the location of pathologic Q waves influences the induc ibility of VT at various right ventricular sites in patients with coro nary artery disease (CAD) and a history of myocardial infarction (MI). In 30 patients with a history of sustained, monomorphic VT, CAD, prio r MI, and pathologic Q waves, programmed ventricular stimulation was p erformed at the right ventricular apex, septum, and outflow tract, in random order. There was electrocardiographic evidence of an MI that wa s inferior in 11 patients, anterior in 10 patients, and both inferior and anterior in 9 patients. Sustained, monomorphic VT was induced in 2 7 of 30 patients (90%). There were no significant differences among th e three sites in the rate of inducibility of VT. The rate of inducible VT at each of the three right ventricular sites was not affected by t he location of prior infarction. In conclusion, among patients with su stained, monomorphic VT, CAD, and a history of MI, the incidence of in ducible sustained, monomorphic VT is not influenced by the location of prior infarction, regardless of whether programmed ventricular stimul ation is performed at the right ventricular apex, septum, or outflow t ract.