Functional paroxysmal ventricular tachycardia ∗

Abstract

P AROXYSMAL ventricular tachycardia is generally considered a manifestation of grave underlying organic heart disease. It is not generally recognized that in approximately 10 to 17 per cent of patients with this arrhythmia, no underlying organic heart disease is found.1-5 Functional paroxysmal ventricular tachycardia may be defined as a succession of four or more independent ventricular contractions originating in either the right or left ventricle, occurring in persons without demonstrable underlying organic heart disease. The onset is usually sudden and is frequently preceded by premature ventricular contractions from one or more foci. The rhythm is fairly regular at a rate usually between 150 and 350 impulses per minute. The paroxysm may last for a few beats or persist for several minutes and, if the rate is moderate, it may persist for hours, day or weeks. The nine patients reported in this paper (Table I) have been studied at Vanderbilt University Hospital during the past 18 years. No evidence of underlying organic cardiovascular disease was found. Thirty other patients with the diagnosis of paroxysmal ventricular tachycardia were also observed and were found to have organic heart disease or the Wolff-Parkinson-White syndrome. It seems unlikely that this is an expression of the true incidence of this rare variety of tachycardia as most instances of death due to ventricular tachycardia are recorded on the basis of the underlying disease. Another factor which makes the true incidence difIicult to establish is the fact that most episodes of functional paroxysmal ventricular tachycardia are of short duration and these subjects are less likely to be hospitalized. Of these nine cases, five patients were men and four were women. Their ages ranged from 2 months to 40 years.