Paroxysmal ventricular tachycardia: A report of five cases

Abstract

Paroxysmal ventricular tachycardia is more common than the number of reported cases would indicate. Five cases are described, illustrating different causes for the attacks. In two, the subjects of advanced myocardial disease with steadily progressing congestive failure, digitalis was the provoking cause of the attacks. The dose of digitalis did not exceed that calculated by the body-weight method of Eggleston. It is concluded that this disorder of rhythm depends more upon the state of cardiac nutrition than upon the degree of concentration of the drug in the tissues. It is suggested that a mechanism, similar to that which underlies the production of auricular fibrillation by digitalis in cases of heart disease with normal rhythm, may also be present in these cases where the drug has provoked ventricular tachycardia. In one case, nicotine intoxication was regarded as an important factor in the production of this arhythmia. Advanced coronary sclerosis and myocardial disease were present in one case, and in the last case no demonstrable cause could be found. Quinidine sulphate was of value in controlling the paroxysms in this case. The prognosis is briefly discussed and emphasis is placed upon closely watching the heart rate in all cases of advanced myocardial failure under treatment with digitalis.