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Bidirectional tachycardia. Mechanism derived from intracardiac recordings and programmed electrical stimulation
Pacing and Clinical Electrophysiology : PACE
|September 1, 1982
Summary
This study investigated bidirectional tachycardia, finding its origin near the His bundle bifurcation. Macroreentry involving the left bundle branch fascicles is suggested as a potential mechanism.
Area of Science:
- Electrophysiology
- Cardiology
Background:
- Bidirectional tachycardia is a rare arrhythmia requiring precise diagnosis.
- Understanding the origin and mechanism of bidirectional tachycardia is crucial for effective management.
Observation:
- His bundle recordings and programmed electrical stimulation were performed in a patient with bidirectional tachycardia.
- Recordings indicated an infra-Hissian origin, near the His bundle bifurcation.
- Alternating VA intervals and interruption by premature beats suggested dual ventricular circuits.
Findings:
- The tachycardia originated infra-Hissian, close to the His bundle bifurcation.
- Evidence suggests two alternating ventricular circuits were involved.
- The mechanism is postulated to be macroreentry involving both left bundle branch fascicles.
Implications:
- This research suggests macroreentry as a possible mechanism for some cases of bidirectional tachycardia.
- Accurate electrophysiological mapping is vital for diagnosing complex arrhythmias.
- Findings contribute to understanding the pathophysiology of ventricular tachycardias.