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Since 1983 we evaluated 57 pts with high grade VA, sustained and
nonsustained VT without evident heart disease (IVA). In 12 cases with right VT the right ventriculography revealed
pseudoaneurysms in right ventricular inflow and/or outflow tract. Biopsy spacemen investigation in 14 pts also found
myocardial fatty infiltration In 11 cases (mainly in pts with left VT) light microscopy biopsy investigation revealed focal
fibrosis, degeneration of myocytes. The typical signs of different stages of apoptosis were found in three pts. The
differences between mean heart rate – RR duration and their standard deviations – SDNN were significantly lower in
IVA than in control group. Thus, in so-called idiopathic VT some invasive methods and biopsy examinations could
reveal structural hear abnormality, including right ventricular dysplasia, chronic myocarditis and apoptosis. VA in pts
without structural abnormality might be critically dependent on autonomic regulation. Our decision regarding “how
to treat idiopathic VA” is based now on the expression of symptoms and heart chamber sizes.
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