Bundle branch reentrant ventricular tachycardia: review and case presentation.

• 影响指数: 1.759
• 发表时间: Aug 2018
• 来源期刊: J Interv Card Electrophysiol
• DOI: 10.1007/s10840-018-0434-z
• PMID: 30155771
• 文章类型: Case Reports
• 中科院分区: Q4
• 方向: 医学
• 作者列表: Romero J,Santangeli P,Pathak RK,Grushko M,Briceno D,Cerrud-Rodriguez R,Quispe R,Grupposo V,Di Biase L

关键词: Bundle branch reentrant ventricular tachycardia (BBRVT); Catheter ablation (CA); Implantable cardioverter-defibrillator (ICD); Ischemic cardiomyopathy (ICM); Ventricular tachycardia (VT); Wide complex tachycardia (WCT)

Mesh: Bundle of His / physiopathology; Cardiomyopathies / etiology physiopathology; Catheter Ablation / methods; Defibrillators, Implantable; Electrocardiography; Electrophysiologic Techniques, Cardiac; Humans; Male; Middle Aged; Myocardial Ischemia / etiology physiopathology; Prognosis; Risk Assessment; Severity of Illness Index; Syncope / etiology physiopathology; Tachycardia, Atrioventricular Nodal Reentry / diagnostic imaging surgery; Treatment Outcome

Abstract

Bundle branch reentrant ventricular tachycardia (BBRVT) is characterized by a unique, fast (200-300 beats/min), monomorphic wide complex tachycardia (WCT) associated with syncope, hemodynamic compromise, and cardiac arrest. It is challenging to diagnose, requiring a His bundle recording and specific pacing maneuvers. The overall incidence has been reported to be up to 20% among patients with non-ischemic cardiomyopathy (NICM) undergoing electrophysiologic studies. We report a case of BBRVT in a patient with ischemic cardiomyopathy (ICM) presenting as a WCT with recurrent implantable-cardioverter-defibrillator (ICD) shocks. We describe all the characteristic features of BBRVT and discuss its differential. We also discuss the role of ablation for this condition.