The arrhythmogenic risk of left ventricular hypertrophy

The incidence of supraventricular and ventricular arrhythmias in patients w ith arterial hypertension is up to 96 % and is about 10 times higher than i n normotensives. Predictors for an increased ventricular arrhythmogenic ris k are left ventricular hypertrophy (LVH), impaired left ventricular functio n with enlarged enddiastolic and endsystolic volumes as well as late potent ials which in case of LVH increase from a 7 % to 18 % incidence. Especially the Simson criteria fQRS and RMS seem to characterize patients at risk. In addition a longer duration of hypertension in conjunction with a higher mu scle mass index and a larger amount of couplets and non-sustained ventricul ar tachycardias, documented by Holter recording, are determinants of life t hreatening arrhythmias. In addition, an increased ventricular vulnerability in electrophysiological study significantly depends on left ventricular hypertrophy. Regression of LVH goes along with a decreased rate of ventricular extrasystoles. We ther efore hypothesize that by pharmacological regression of hypertrophy the pre valence of complex arrhythmias decreases.