[Ventricular nodal reentry tachycardia without ventricular dilatation: diagnosis and treatment by radiofrequency catheter ablation].
Bundle branch reentry tachycardia has been reported in patients with left ventricular dilatation, especially in those with dilated cardiomyopathy and aortic regurgitation. These patients show aspecific intraventricular conduction delay on the ECG and a prolonged H-V interval at the electrophysiologic study. We report 2 cases of bundle branch reentry tachycardia in patients without left ventricular enlargement to help the correct diagnosis of the arrhythmia. A correct diagnosis is very important because bundle branch reentry tachycardia is easily and safely treated by right bundle transcatheter radiofrequency ablation. We also report electrophysiologic characteristics we found during the study and the ablation: -contrary to the data reported in literature, at ventricular tachycardia starting, modifications of the V-V interval are not always preceded by similar variations in the H-H interval. -during right bundle radiofrequency ablation, a QRS narrowing may precede right bundle branch block appearance. This QRS normalisation should induce to continue and not to stop energy delivering.
Pandozi
C
C
Dipartimento delle Malattie del Cuore, Ospedale S. Fillippo Neri, Roma.
Castro
A
A
Toscano
S
S
Villani
M
M
Santini
M
M
D000368:Aged; D002037:Bundle-Branch Block / Q000175:diagnosis; D006332:Cardiomegaly / Q000175:diagnosis; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis
Tachicardia ventricolare da rientro branca-branca in assenza di dilatazione ventricolare: diagnosi e trattamento mediante ablazione transcatetere a radiofrequenza.