Bundle branch re-entry ventricular tachycardia in a patient with myotonic dystrophy.
Bundle branch re-entry (BBR)-ventricular tachycardia (VT) is relatively rare with an incidence of about 6% in sustained monomorphic VT series. However, physicians unexpectedly encounter it in clinical practice. BBR-VT is associated with serious hemodynamic decompensation, and the clinical presentation in approximately 75% of patients with inducible BBR-VT is syncope or cardiac sudden death. Thus, precise mapping of His-Purkinje and bundle branch potentials is necessary for an accurate diagnosis and treatment of re-entrant mechanisms especially for BBR-VT. However, simultaneous recording of both the left-bundle (LB) and right-bundle (RB), as well as His-bundle (HB), potentials is often difficult during tachycardia. Here we report the clear documentation of the activation sequence of the His-Purkinje system during BBR-VT, which could be readily and completely treated by radiofrequency catheter ablation in a myotonic dystrophy patient.
Takeda
Kotaro
K
Department of Cardiovascular Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka, Japan.
Takemoto
Masao
M
Mukai
Yasushi
Y
Seto
Taku
T
Ohwaki
Kazuo
K
Kaji
Yoshikazu
Y
Chishaki
Akiko
A
Sunagawa
Kenji
K
D000328:Adult; D002036:Bundle of His / Q000503:physiopathology*; D017115:Catheter Ablation; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D009223:Myotonic Dystrophy / Q000150:complications*; D011690:Purkinje Fibers / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome