Ventricular tachycardia with two variable foci.

Torsades de pointes results from a ventricular tachycardia with two variable foci, and when considered in detail, can be differentiated from patterns of bulging of ventricular fibrillation. Episodes of bulging electrical activity seen during complete His bundle block are therefore not due to ventricular fibrillation, although they can degenerate into ventricular fibrillation. The existence of a spontaneously reversible ventricular fibrillation in normothermic conditions in humans can only be established with concurrent synchronized recordings. The very important phenomenon of the interruption of coordinated activation during reoxygeneration and rewarming requires further study. The progressive variations of signal amplitude result from the activity of at least two simultaneous phenomena.

[The plateau of the apex cardiogram]. / Le plateau du cardiogramme de pointe

The apex cardiogram should normally include a flat part, but when one looks carefully, one may note that this flat part normally includes a flat wave between the descending part from the first summit and the part rising towards the second summit. This is therefore something which occurs in the middle of systole. Now, quite different curves, such as those of ventricular volume collected by rheography or cineangiography, also show a mesodiastolic occurence. As far as clinical medicine is concerned, it is expressed more frequently during proto or telesystole, rather than during mesosystole, which may be totally free of abnormal waves. What thus occurs in mesosystole? This is the question which is raised by these findings]