[Vector cardiographic evaluation of monomorphic ventricular tachycardia; its relation to the type of cardiopathy, vagal tonus and the prevalence of late potentials].

The most common cause of sudden death is malignant ventricular arrhytHmia. In order to identify the predictive value of the vectospatial evaluation in the surface electrocardiogram during a monomorphic ventricular tachycardia (MVT), and the equilibrium state of AutonomOus Nervous System (ANS), 89 patients of both sexes were studied with mean age of 47 +/- 16.2 years. They were grouped as follows: Group I included 43 patients (P), with a coronary heart disease; Group II (n = 24P) with a noncoronary myocardiopathy and Group III (n = 22P) with unknown origin MVT (Cryptogenic). Relationship between QRS configuration in the frontal plane (QRSf) during MVT episode with transverse plane, cardiac position in the chest X-rays, presence and duration of late potentials (LPs) in their two types of analysis (time domain and spectral mapping by high-resolution electrocardiogram), heart rate variability and ejection fraction by echocardiography were determined in all patients. The QRSf configuration with left bundle-branch block (LBBB) was the most common in group I, the sustained MVT (SMVT) + LBBB was associated with both prevalence and duration of late potentials (p = 0.005), low-rate heart variability and ejection fraction < 40%. SMVT + LBBB was the most common type in group III and if it has shown and inferior axis, an elevated rate of LPs (+) was seen. Situation that oriented to an arrhythmogenic right ventricular dysplasia. Low amplitude signals with short duration in the time domain were seen in group I with LBBB; and with SMVT + RBBB in group II. We suggest that vectospatial evaluation of QRSf during a MVT is a greater importance in the risk stratification for sudden death and it can guide to anatomic origin and the diagnosis-therapeutic approach.