Rapid ventricular tachycardia due to His-Purkinje reentry.
Two patients developed rapid His-Purkinje reentrant tachycardia during programmed ventricular stimulation for evaluation of recurrent ventricular tachycardia. In Patient 1, His-Purkinje reentry induced a morphologically distinct ventricular tachycardia which may have been a reentrant circuit operating independently for several cardiac cycles. His-Purkinje reentry was not inducible in Patient 2 until lidocaine was given. Following lidocaine administration, sustained His-Purkinje reentrant tachycardia was initiated by 2 premature ventricular stimuli. The tachycardia was rapid (240 beats per minute) and required cardioversion.
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D002036:Bundle of His / Q000187:drug effects / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008012:Lidocaine; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology; D011342:Procainamide / Q000627:therapeutic use; D011690:Purkinje Fibers / Q000187:drug effects / Q000503:physiopathology*; D013610:Tachycardia / Q000188:drug therapy / Q000503:physiopathology*
D008012:Lidocaine; D011342:Procainamide; D000638:Amiodarone