Bidirectional Ventricular Tachycardia Caused by a Reentrant Mechanism With Left Bundle Branch Block Configuration on Electrocardiography

Reentrant bidirectional ventricular tachycardia (VT) with left bundle branch block (LBBB) configuration was diagnosed in a 54-year-old woman who showed 2 types of VT: QRS morphologies of LBBB with inferior axis and LBBB with superior axis. The development of VT with a superior axis was preceded by V...

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Bibliographic Details
Published in:Circulation Journal 2008, Vol.72(8), pp.1373-1377
Main Authors: Ueda-Tatsumoto, Akiko, Sakurada, Harumizu, Nishizaki, Mitsuhiro, Okazaki, Hidetaka, Komiyama, Kota, Mizusawa, Yuka, Tejima, Tamotsu, Hiraoka, Masayasu
Format: Article
Language:English
Subjects:
Action Potentials
Bidirectional ventricular tachycardia
Bundle-Branch Block - complications
Bundle-Branch Block - diagnosis
Bundle-Branch Block - physiopathology
Bundle-Branch Block - surgery
Catheter Ablation
Electro-anatomical mapping
Electrocardiography
Electrophysiologic Techniques, Cardiac
Entrainment
Female
Heart Conduction System - physiopathology
Humans
Middle Aged
Radiofrequency catheter ablation
Tachycardia, Ventricular - etiology
Tachycardia, Ventricular - physiopathology
Tachycardia, Ventricular - surgery
Time Factors
Treatment Outcome
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Summary:Reentrant bidirectional ventricular tachycardia (VT) with left bundle branch block (LBBB) configuration was diagnosed in a 54-year-old woman who showed 2 types of VT: QRS morphologies of LBBB with inferior axis and LBBB with superior axis. The development of VT with a superior axis was preceded by VT with inferior axis and/or both configurations of VT in alternate beats exhibiting bidirectional VT. The electrophysiological study demonstrated reproducible induction of both types of VT by programmed ventricular stimulation and both types of VT were entrained. Using conventional pace mapping and electro-anatomical mapping methods, radiofrequency energy applications at the 2 exit sites of the reentry path successfully terminated both types of VT and the patient was free from VT attacks for more than 15 months. (Circ J 2008; 72: 1373 - 1377)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.72.1373