Arrhythmogenic Pattern of Coronary Artery Disease in Patients With Inducible Sustained Ventricular Tachycardia

This study was performed to determine the relation between inducible sustained ventricular tachycardia (ISVT) by programmed electrical stimulation and angiographic, clinical and echographic data in patients with coronary artery disease. The aim of this study was to explore if these inducible arrhythmias are associated with any specific “arrhythmogenic” pattern of coronary artery disease. 129 consecutive patients with coronary artery disease and ISVT were evaluated by left ventriculography and coronary arteriography by standard techniques. The mean age of the patients was 46 years with a range of 21 to 72 years, 74% of them were males. A significant stenosis of the main left coronary artery (>50%) appeared to be more frequent in arrhythmia patients (31%). Also proximal left anterior descending artery stenosis was more frequent in in the arrhythmia patients (48%). “Main left equivalent” lesions, defined as a significant stenosis of the proximal left anterior descending artery and the proximal left circumflex artery was significantly more frequent among the arrhythmia patients (51%). Using the quantitive wall motion analysis, a strong relationship was found between the number of abnormally contracting segments and the presence of inducible sustained ventricular tachycardia. The results of the present study suggest that ISVT in patients with coronary artery disease are more frequently associated with lesions of the main left coronary artery or the proximal left anterior descending artery.