13th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 1998

January 24-31, 1998
Marilleva, Trento, Italy

RT-124

Myocardial structure: its contribution to arrhythmogenesis

D.H. Cox, R.W.F. Campbell.
Academic Cardiology Department, Freeman Hospital, Newcastle upon Tyne, UK

Introduction

Cardiac arrhythmias are defined by their mechanism and by their anatomy. The anatomic label may merely be a marker of site of origin, but in a growing number of situations, discreet, anatomical abnormalities are known to be responsible for the generation of arrhythmias. Thus a variety of common, repetitive arrhythmias ranging from the reciprocating tachycardias through to post infarction ventricular tachycardia, are based on pathological structures or disruption of normal myocardial architecture.

Myocardial structure may also contribute to arrhythmogenesis in more general ways. Atrial disease is known to predispose to atrial fibrillation¹. Ventricular arrythmias occur most frequently in the setting of ventricular dilatation^2,3. Ventricular stretch has been shown to be arrhythmogenic in animal models⁴ demonstrating the relationship between altered myocardial structure and arrythmia⁵. In a similar manner, the process of left ventricular hypertrophy is associated with increased rates of sudden death^6-8.