Article Text

Download PDFPDF
Haemodynamic and catecholamine response to simulated ventricular tachycardia in man: effect of baseline left ventricular function

Abstract

Objective: To examine the effects of baseline left ventricular function on the haemodynamic and catecholamine responses to ventricular tachycardia.

Design: Experimental cohort study.

Setting: Cardiac catheterisation laboratory in tertiary referral centre.

Subjects: 24 patients (19 male, 5 female; mean (SD) age, 59 (10) years) without coronary artery disease, divided into two groups with normal or impaired left ventricular function: group A, ejection fraction > 65% (n = 10); group B, ejection fraction < 45% (n = 14). Other medical and demographic factors were similar in the two groups.

Interventions: Ventricular tachycardia was simulated with rapid pacing at 150 beats/min for 10 minutes.

Main outcome measures: Arterial blood pressure; venous plasma catecholamine concentrations.

Results: During rapid pacing, blood pressure was lower in group B (with impaired left ventricular function) than in group A: systolic blood pressure, 102 (11) v 115 (9) mm Hg (p = 0.005); mean blood pressure, 79 (6) v 85 (6) mm Hg (p = 0.02). The ejection fraction correlated with the lowest systolic blood pressure (r = 0.64, p = 0.0006). Although the rise in adrenaline was comparable between the two groups, the rise in noradrenaline was more pronounced (p < 0.05) in patients in group B.

Conclusion: At low rates and in selected patients, the underlying state of left ventricular function affects haemodynamic tolerance of ventricular tachycardia. Patients with impaired left ventricular function have a lower blood pressure during ventricular tachycardia, despite an exaggerated noradrenaline release.

  • ventricular tachycardia
  • catecholamines
  • left ventricular function

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.