Repetitive polymorphic ventricular tachycardia initiated by phase 4 block in the His-Purkinje system.
We report a case of a patient who developed repetitive episodes of polymorphic ventricular tachycardia with a stereotypical pattern of initiation. A premature atrial complex would result in a brief pause followed by left bundle branch block aberrancy. Ventricular bigeminy would ensue followed by episodes of polymorphic ventricular tachycardia, some requiring cardioversion. We postulate that delay within the His-Purkinje system initiated by phase 4 block was proarrhythmic in this patient.
Dizon
Jose'
J
Division of Cardiology, Department of Medicine, Columbia University Medical Center Columbia University, New York, NY 10604, USA. jmd11@columbia.edu
Wang
Daniel
D
Vainrib
Alan
A
D000368:Aged; D002036:Bundle of His / Q000503:physiopathology*; D002037:Bundle-Branch Block / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D011690:Purkinje Fibers / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000503:physiopathology*