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 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.
Ueda-Tatsumoto
Akiko
A
Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, and Department of Cardiovascular Diseases, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan. a_tatsumoto@yahoo.co.jp
Sakurada
Harumizu
H
Nishizaki
Mitsuhiro
M
Okazaki
Hidetaka
H
Komiyama
Kota
K
Mizusawa
Yuka
Y
Tejima
Tamotsu
T
Hiraoka
Masayasu
M
D000200:Action Potentials; D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome