[Ventricular arrhythmias in patients with ischemic heart disease: a possible role of the autonomous nervous system].

To reveal possible factors that initiate ventricular arrhythmias (VA) in patients with coronary heart disease (CHD), a total of 44 patients with documented coronary artery stenosis were examined. The patients underwent coronary ventriculography, bicycle ergometry, 24-hour Holter monitoring, and examination of the autonomic nervous system (ANS). In 24 patients (Group 1), myocardial ischemic episodes were accompanied by VA. The latter were absent in myocardial ischemia in 20 patients (Group 2). In the two groups, there were no statistically significant differences in parameters, such as severity of atherosclerotic lesion of coronary arteries, total ejection fraction, existence of regional asynergy, exercise tolerance, number of daily myocardial ischemic episodes, their duration, degree of ST segment displacement. Increased activity of the sympathetic ANS was detected in 20 (83.3%) patients from Group 1 and only in 3 (15%) from Group 2 (p < 0.05). It is suggested that enhanced functional activity of ANS may be a prerequisite for displaying arrhythmogenic mechanisms in myocardial ischemia.