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Related Experiment Videos

Bundle branch reentrant ventricular tachycardia.

Alexander Mazur1, Jairo Kusniec, Boris Strasberg

  • 1Cardiology Department, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel. amazur@netvision.net.il

Indian Pacing and Electrophysiology Journal
|September 1, 2006
PubMed
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Bundle branch reentrant (BBR) tachycardia, a rare ventricular tachycardia (VT), involves both bundle branches in its circuit. Radiofrequency ablation of the right bundle branch is a curative treatment for this condition.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Bundle branch reentrant (BBR) tachycardia is an uncommon ventricular tachycardia (VT) involving both bundle branches.
  • It typically affects patients with acquired heart disease and conduction system impairment, but can occur in those with structurally normal hearts.
  • Patients often present with syncope or presyncope due to rapid VT rates exceeding 200 bpm.

Purpose of the Study:

  • To describe the characteristics, diagnosis, and management of bundle branch reentrant tachycardia.
  • To highlight the role of electrophysiological studies and ablation in treating BBR tachycardia.
  • To discuss the long-term outcomes and risk stratification for patients with BBR tachycardia.

Main Methods:

  • Electrophysiological study with pacing maneuvers to diagnose BBR tachycardia.

Related Experiment Videos

  • Radiofrequency catheter ablation, specifically targeting the right bundle branch, as a therapeutic intervention.
  • Assessment of His-ventricular (H-V) interval in sinus rhythm and analysis of QRS morphology during tachycardia.

    • Main Results:

    • BBR tachycardia involves both bundle branches in the reentry circuit, often presenting with left bundle branch block morphology.
    • A prolonged His-ventricular (H-V) interval in sinus rhythm is common but not universal.
    • Radiofrequency ablation of the right bundle branch is a highly effective curative therapy.
    • The incidence of pacemaker implantation varies (0-30%), and long-term outcomes depend on underlying cardiac disease.

    Conclusions:

    • Bundle branch reentrant tachycardia can be effectively diagnosed and cured with radiofrequency ablation, primarily of the right bundle branch.
    • Patients with significant left ventricular dysfunction require careful risk stratification and may benefit from an implantable cardiovertor-defibrillator.
    • Understanding the electrophysiological mechanisms is crucial for successful management of this uncommon VT.