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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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[Ventricular tachycardia due to branch to branch re-entry]

J L Pasquié1, J C Macia, F Leclercq

  • 1Hôpital Arnaud de Villeneuve, CHU Montpellier, 34295 Montpellier 5. jl-pasquie@chu-montpellier.fr

Archives Des Maladies Du Coeur Et Des Vaisseaux
|January 26, 2006
PubMed

Insights

Branch to branch re-entry ventricular tachycardia is a rare condition often seen in Steinert's disease. Ablation of the right bundle branch is the most effective treatment for this specific type of tachycardia.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Anatomy

Context:

  • Branch to branch re-entry ventricular tachycardia is a rare clinical entity.
  • This circuit involves the His bundle branches, often occurring with left ventricular dilatation and conduction defects.
  • It is frequently associated with Steinert's disease (myotonic dystrophy).

Purpose:

  • To describe the rare entity of branch to branch re-entry ventricular tachycardia.
  • To outline diagnostic criteria and effective treatment strategies.

Summary:

  • Diagnosis can be challenging, relying on His potential recordings showing His activity preceding ventriculograms and variations in cycle lengths.
  • Atrial capture without QRS modification may occur, but fusion excludes the diagnosis.
  • Drug therapy is minimally effective; ablation of the right bundle branch of the His is the definitive treatment, successfully terminating the tachycardia.

Impact:

  • Provides a comprehensive overview of a rare tachycardia mechanism.
  • Highlights the importance of electrophysiological study in diagnosis.
  • Establishes right bundle branch ablation as the gold standard treatment, offering a definitive solution for patients.

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