Abstract des Autors

Ventricular tachyarrhythmias, due to abnormal automaticity, triggered activity, reentry, can occur in young people who practice sport. Congenital or acquired heart disease can be responsible for them. Anomalous origin of coronary arteries or coronary spasm should be suspected when the arrhythmias are preceded by episodes of acute myocardial ischemia. In general the possibility of latent heart disease (some forms of hypertrophic or dilated cardiomyopathy, myocarditis, arrhythmogenic right ventricular dysplasia, should always be considered and investigated. In most cases, however, the arrhythmias occur in subjects with normal heart. Idiopathic right ventricular tachyarrhythmias, including extrasystoles and paroxysmal or repetitive tachycardia, have characteristically a left bundle branch block and right axis deviation contour suggesting their origin from the right ventricular outlow tract. They are triggered arrhythmias and most of them are benign. Their association with right ventricular dysplasia which can favour their transformation into serious reentrant arrhythmias should be suspected on some occasions. Electrophysiologically and clinically similar but less common idiopathic left ventricular tachyarrhythmias, also called fascicular ventricular tachyarrhythmias have characteristically a right bundle block and left axis deviation contour suggesting their origin from the left ventricular outflow tract. In young subjects with congenital long QT syndromes a typical and well known arrhythmia can be found, the 90 called torsage de pointe ventricular tachycardia. This is probably a triggered arrhythmia which can sometimes transform into a very serious and possibly lethal reentrant arrhythmia. Also serious and possibly lethal are some types of polimorphic ventricular tachycardia (reentrant arrhythmia) occurring in young subjects without QT prolongation: Brugada's syndrome and other similar syndromes are characterized by arrhythmias of this type. Verf.-Referat