Brugada et al identified different mechanisms for ventricular tachycardia acceleration during programmed electrical stimulation. The authors are from University of Limburg in Maastricht.
Patient selection: acceleration of ventricular tachycardia during programmed electrical stimulation
Parameters:
(1) QRS complex morphology before and after stimulation
(2) cycle length as percent of that seen with original VT
(3) cycle length relative to refractory period in milliseconds
QRS Morphology
Cycle Length vs Original
Cycle Length vs Refractory Period
Mechanism
same
< 70%
< RP + 30
double-wave re-entry
same
< 70^
>= RP + 3-
double-wave re-entry
different
>= 70%
< RP + 30
functional circuit
different
< 70%
< RP + 30
functional circuit
same
>= 70%
< RP + 30
faster anatomic circuit with same exit point
same
>= 70%
>= RP + 30
faster anatomic circuit with same exit point
different
< 70%
>= RP + 30
faster anatomic circuit with different exit point
different
>= 70%
>= RP + 30
faster anatomic circuit with different exit point
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