Repetitive polymorphic ventricular tachycardia initiated by phase 4 block in the His-Purkinje system
Jose' Dizon1, Daniel Wang, Alan Vainrib
1Division of Cardiology, Department of Medicine, Columbia University Medical Center Columbia University, New York, NY 10604, USA. jmd11@columbia.edu
Abstract:
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.
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