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Incomplete bundle-branch block and ST-segment elevation: syndrome associated with sustained monomorphic ventricular
B Brembilla-Perrot1, D Beurrier, L Jacquemin
1CHU of Brabois, Vandoeuvre les Nancy, France.
Insights
This study identifies a specific electrocardiogram (ECG) pattern linked to ventricular tachycardia in patients with healthy hearts. This ECG finding, though variable, indicates a good prognosis for tachycardia management.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Sustained monomorphic ventricular tachycardia (SMVT) typically suggests underlying structural heart disease.
- Identifying the etiology of SMVT in patients with structurally normal hearts remains challenging.
- Subtle electrocardiogram (ECG) findings can be crucial for diagnosing cardiac conditions.
Abstract:
This paper reports on three cases of patients with an apparently normal heart admitted for sustained monomorphic ventricular tachycardia. The only abnormal finding showed in the electrocardiogram (ECG) in sinus rhythm that exhibited an entity associated with incomplete right bundle-branch block and persistent ST-segment elevation. The ECG entity was variable and disappeared transiently. Spontaneous ventricular tachycardia in one patient was inducible by programmed stimulation. There was no underlying heart disease. The origin of the ventricular tachycardia in one patient was located by pace mapping in the left ventricle at the left ventricular basal septum. The follow-up (from 6 months up to 6 years) demonstrated a good prognosis. This particular ECG entity associated with monomorphic ventricular tachycardia could have been missed because of the variations in the ECG in sinus rhythm and was associated with a favorable prognosis.