Bundle branch reentrant ventricular tachycardia: review and case presentation
Jorge Romero1, Pasquale Santangeli2, Rajeev K Pathak3
1Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA.
Summary
Bundle branch reentrant ventricular tachycardia (BBRVT), a fast, wide complex tachycardia, can cause syncope and hemodynamic compromise. This case highlights BBRVT in ischemic cardiomyopathy, often presenting with implantable cardioverter-defibrillator shocks.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Bundle branch reentrant ventricular tachycardia (BBRVT) is a rare, life-threatening arrhythmia.
- It typically presents as a fast (200-300 bpm), monomorphic wide complex tachycardia (WCT).
- Diagnosis can be challenging, often requiring electrophysiologic study with His bundle recordings and pacing maneuvers.
Observation:
- This report details a case of BBRVT in a patient with ischemic cardiomyopathy (ICM).
- The patient presented with recurrent wide complex tachycardia and implantable cardioverter-defibrillator (ICD) shocks.
- Characteristic BBRVT features were observed, differentiating it from other WCTs.
Findings:
- BBRVT can occur in patients with ischemic cardiomyopathy, not exclusively non-ischemic cardiomyopathy.
- Recurrent ICD shocks can be a manifestation of BBRVT.
- Specific pacing maneuvers during electrophysiologic study are crucial for diagnosis.
Implications:
- This case expands the known spectrum of BBRVT presentation.
- It underscores the importance of considering BBRVT in patients with ICM and WCT, especially those with ICDs.
- Catheter ablation may be a viable treatment option for BBRVT in this population.
Keywords:
Bundle branch reentrant ventricular tachycardia (BBRVT)Catheter ablation (CA)Implantable cardioverter-defibrillator (ICD)Ischemic cardiomyopathy (ICM)Ventricular tachycardia (VT)Wide complex tachycardia (WCT)More Related Videos
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