Left Ventricular Aneurysm Presenting as Bidirectional Ventricular Tachycardia.
Abdulah Alrifai1, Mohamad Kabach1, Jonathan Nieves1
1Department of Cardiology, University of Miami/JFK Medical Center, Atlantis, FL.
Ochsner Journal
|October 3, 2018
Summary
Bidirectional ventricular tachycardia, a rare arrhythmia, can originate from left ventricular aneurysms. Ventricular tachycardia ablation successfully treated a patient with this rare condition.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
Background:
- Bidirectional ventricular tachycardia is a rare ventricular arrhythmia with a 180-degree shift in the mean QRS axis.
- Common causes include digitalis toxicity, myocarditis, and channelopathies.
Observation:
- A 73-year-old male presented with chest pressure and near syncope.
- Electrocardiogram revealed sustained bidirectional ventricular tachycardia.
- Echocardiogram showed severe anterior hypokinesis, reduced ejection fraction (35%), and an apical ventricular aneurysm.
Findings:
- Electrophysiology study identified the apical ventricular aneurysm as the source of the bidirectional arrhythmia.
- The patient's condition was successfully treated with ventricular tachycardia ablation.
Implications:
- This case highlights a unique origin of bidirectional ventricular tachycardia from an apical left ventricular aneurysm.
- Ventricular tachycardia ablation can be an effective treatment for arrhythmias originating from ventricular aneurysms.
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