title: Incessant slow bundle branch reentrant ventricular tachycardia in a young patient with left ventricular noncompaction.
abstract: A 15-year-old girl was admitted to the cardiology outpatient clinic due to mild palpitations and documented incessant slow ventricular tachycardia (VT) with left bundle branch block (LBBB) pattern. The baseline electrocardiogram revealed first-degree atrioventricular block and intraventricular conduction defect. Transthoracic echocardiography showed prominent trabeculae and intertrabecular recesses suggesting left ventricular noncompaction (LVNC), which was confirmed by cardiac magnetic resonance imaging. During electrophysiological study, a sustained bundle branch reentrant VT with LBBB pattern and cycle length of 480 ms, similar to the clinical tachycardia, was easily and reproducibly inducible. As there was considerable risk of need for chronic ventricular pacing following right bundle ablation, no ablation was attempted and a cardioverter-defibrillator was implanted. To the best of our knowledge, no case reports of BBR-VT as the first manifestation of LVNC have been published. Furthermore, this is an extremely rare presentation of BBR-VT, which is usually a highly malignant arrhythmia.
authors.affiliation: Cardiology Department, Coimbra Hospital and University Centre, Coimbra, Portugal. sergioncbarra@gmail.com
authors.forename: Sérgio
authors.initials: S
authors.lastname: Barra
authors.forename: Nuno
authors.initials: N
authors.lastname: Moreno
authors.forename: Rui
authors.initials: R
authors.lastname: Providência
authors.forename: Helena
authors.initials: H
authors.lastname: Gonçalves
authors.forename: João José
authors.initials: JJ
authors.lastname: Primo
mesh_terms: D000293:Adolescent; D002037:Bundle-Branch Block / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000150:complications* / Q000503:physiopathology; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications* / Q000503:physiopathology
keywords: Automatic implantable cardioverter-defibrillator; Bundle branch reentrant ventricular tachycardia; Cardioversor-desfibrilhador implantável; Electrophysiologic study; Estudo electrofisiológico; Left ventricular noncompaction; Taquicardia ventricular por reentrada de ramo; Ventrículo esquerdo não-compactado