Keiichi Kuwaki

Resetting of tachycardia cycle by single and double ventricular extrastimuli in recurrent sustained ventricular tachycardia.

In two cases with recurrent sustained ventricular tachycardia (VT) due to re‐entry, the response pattern to extrastimuli during the tachycardia was studied. In each case, right ventricular extrastimuli with longer coupling intervals during VT were followed by fully compensatory pauses and with shorter coupling intervals reset the tachycardia cycle. In one case, a plateau was produced by a single extrostimulus, resembling that seen in the response curve of sinus node automaticity as well as ectopic atrial tachycardia. Two successive stimuli produced three definite zones, i.e., fully compensatory, reset producing a plateau, and progressive prolongation zones with shortening of the coupling intervals between the two stimuli, and terminated the tachycardia with further shortening of the coupling intervals. In conclusion, resetting phenomenon was confirmed on two cases with re‐entrant VT. This phenomenon cannot be used as a criterion to determine the mechanism responsible for VT.