Progressive outcomes of bundle branch reentrant ventricular tachycardia in patients without structural heart disease
Zhaomin Li1, Xiafeng Peng1, Chang Cui1
1Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Background:
Ablation strategies to treat bundle branch reentrant ventricular tachycardia (BBRT) are well described. However, reports of long-term follow-up outcomes in BBRT patients without structural heart disease (SHD) are limited.
Objective:
The purpose of this study was to investigate the long-term follow-up prognosis of BBRT patients without SHD.
Methods:
Changes in electrocardiographic and echocardiographic parameters were used to evaluate progression during follow-up. Potential pathogenic candidate variants were screened using a specific gene panel.
Results:
Eleven consecutive BBRT patients without obvious SHD based on echocardiographic and cardiovascular magnetic resonance imaging results were enrolled. Median age was 20 (11-48) years, and median follow-up time was 72 months. During follow-up, PR interval [206 (158-360) ms vs 188 (158-300) ms; P = .018] and QRS duration [187 (155-240) ms vs 164 (130-178) ms; P = .008] each increased significantly compared with postablation. Right- and left-sided chamber dilation and reduced left ventricular ejection fraction (LVEF) also were observed. Clinical deterioration or events occurred in 8 patients: 1 sudden death; 3 both complete heart block and reduced LVEF; 2 significantly reduced LVEF; and 2 prolonged PR interval. Genetic testing results showed that 6 of 10 patients (excluding the patient with sudden death) had ≥1 potential pathogenic candidate variants.
Conclusion:
Further deterioration of His-Purkinje system conduction was observed in young BBRT patients without SHD after ablation. The His-Purkinje system may be the first target of genetic predisposition.
More Related Videos
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
Related Concept Videos
Dysrhythmias II: Classification of Tachyarrhythmias
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias IV: Characteristics of Bradyarrhythmias
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Cardiomyopathy II: Dilated Cardiomyopathy
