Characteristics of bundle branch reentrant ventricular tachycardia with a right bundle branch block configuration: feasibility of atrial pacing.
OBJECTIVE
We assessed the inducibility of bundle branch reentrant ventricular tachycardia (BBR-VT) with a right bundle branch block (RBBB) configuration in patients with BBR-VT.


RESULTS
Eight consecutive patients (5 men, 45+/-18 years old) with inducible BBR-VT were included. We evaluated the clinical and electrophysiological characteristics in these patients to explore the inducible factors of BBR-VT with an RBBB configuration. Six of eight patients had inducible BBR-VT with an RBBB configuration, including four patients with a clinical VT with the same QRS morphology. All patients exhibited an LBBB or RBBB type intraventricular conduction disturbance during sinus rhythm. The mean HV interval at baseline was 79+/-18 ms. The reproducibility of the BBR-VT with an RBBB pattern was achieved by incremental atrial pacing during an isoproterenol infusion in 4/6 patients (67%) and by programmed ventricular stimulation in the other two. After a right bundle ablation, the BBR-VT was no longer inducible in any of the cases.


CONCLUSIONS
Our results indicate that it is not rare to induce BBR-VT with an RBBB configuration. For the induction of an RBBB type BBR-VT, incremental atrial pacing may play a significant role in addition to ventricular pacing.
Mizusawa
Yuka
Y
Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10, Ebisu, Shibuya-ku, and Tokyo Medical and Dental University, Tokyo 150-0013, Japan. yuka_m12@msn.com
Sakurada
Harumizu
H
Nishizaki
Mitsuhiro
M
Ueda-Tatsumoto
Akiko
A
Fukamizu
Seiji
S
Hiraoka
Masayasu
M
D000328:Adult; D000368:Aged; D002037:Bundle-Branch Block / Q000150:complications* / Q000175:diagnosis* / Q000517:prevention & control; D004562:Electrocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications* / Q000175:diagnosis / Q000517:prevention & control*; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000175:diagnosis* / Q000517:prevention & control; D016896:Treatment Outcome