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His bundle electrogram during bidirectional tachycardia.

S Gavrilescu, C Luca

    British Heart Journal
    |November 1, 1975
    PubMed
    Summary
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    Digitalis intoxication can cause bidirectional tachycardia in patients. This case reveals two distinct electrical foci, one junctional and one fascicular, responsible for the arrhythmia.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Pharmacology

    Background:

    • Digitalis glycosides are commonly used for heart failure and arrhythmias.
    • Digitalis intoxication can lead to a spectrum of cardiac arrhythmias.
    • Bidirectional tachycardia is a rare but serious complication.

    Observation:

    • A 66-year-old woman presented with bidirectional tachycardia.
    • The patient had evidence of digitalis intoxication.
    • His bundle recordings were utilized for diagnostic purposes.

    Findings:

    • His bundle electrograms identified two distinct arrhythmogenic foci.
    • One focus was identified as junctional in origin.
    • The second focus was identified as fascicular in origin.

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    Implications:

    • This case highlights the importance of considering digitalis toxicity in patients with bidirectional tachycardia.
    • Understanding the specific arrhythmogenic foci can guide therapeutic strategies.
    • Accurate diagnosis of the origin of tachycardia is crucial for effective management.