[Bidirectional ventricular tachycardias].
Bidirectional tachycardias are rare arrhythmias. Nevertheless in the sixties and seventies these arrhythmias prompted much work relating to their mechanism. Discussions about the supposed supra-ventricular origin of certain bidirectional tachycardias essentially rested on presumptive arguments based on electrocardiographic analysis. All the electrophysiological investigations which could be performed in tachycardia showed a ventricular origin. The current hypotheses concerning the electrophysiological mechanism favour non-unifocal mechanisms as well as a very diverse aetiology: an automatic focus, or the triggered activities being associated with alternating conduction, or re-entry between the left hemibranches. Although the classic context is of excess digitalis with advanced cardiopathy, readily in atrial fibrillation with a poor prognosis as a corollary, the most recent description of catecholergic ventricular tachycardias with the very characteristic appearance of bidirectional tachycardias justifies updating the understanding of these unusual tachycardias.
Leenhardt
A
A
Service de cardiologie, hôpital Lariboisière, Paris. antoine.leenhardt@lrb.ap-hop-paris.fr
Extramiana
F
F
Milliez
P
P
Denjoy
I
I
Thomas
O
O
Meddane
M
M
Dejode
P
P
Cauchemez
B
B
D004562:Electrocardiography; D004594:Electrophysiology; D006801:Humans; D017180:Tachycardia, Ventricular / Q000503:physiopathology*