Idiopathic recurrent sustained ventricular tachycardia responsive to verapamil.

The role of i.v. verapamil in the management of atrioventricular (AV) nodal reentrant tachycardias is well established (Schamroth et al., 1980). Generally however the drug is not very effective in recurrent ventricular tachycardia (VT) (Singh et al., 1983). Verapamil was recently demonstrated to be successful in terminating VT induced by programmed stimulation in only 1 out of 8 patients tested (Wellens et al., 1980). Conversely a few recent cases of verapamil responsive VT, mostly occurring in young people without obvious organic heart disease, have been reported (Belhassen, 1984; Klein, 1984; Delise, 1985; Ward, 1984; Lin 1983; German, 1983; Mason, 1983; Wu, 1981). We describe 3 clinical examples of idiopathic recurrent sustained VT responsive to verapamil. A careful analysis of our cases support the hypothesis of different pathophysiologic mechanism involved in the genesis of this unique arrhythmic entity.