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Adenosine-sensitive bundle branch reentry

D S Rubenstein1, M C Burke, J G Kall

  • 1Electrophysiology Laboratory, University of Chicago Hospitals, IL 60637, USA.

Journal of Cardiovascular Electrophysiology
|January 1, 1997
PubMed
Summary
This summary is machine-generated.

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Adenosine can terminate rare ventricular tachycardias caused by bundle branch reentry. This finding suggests adenosine may treat certain reentrant arrhythmias beyond triggered activity.

Area of Science:

  • Electrophysiology
  • Cardiology

Background:

  • Bundle branch reentry is an uncommon cause of ventricular tachycardia.
  • Interfascicular reentry, involving both left bundle fascicles, is even rarer.
  • The impact of adenosine on bundle branch reentry tachycardia is not well understood.

Observation:

  • A patient with symptomatic wide complex tachycardias underwent electrophysiologic study.
  • Tachycardia consistent with left interfascicular reentry was induced during isoproterenol infusion.
  • Intravenous adenosine successfully terminated the tachycardia.

Findings:

  • Adenosine effectively terminated bundle branch reentry tachycardia.
  • Radiofrequency ablation at the left posterior fascicle exit site prevented recurrence.
  • The patient remained free of tachycardia during long-term follow-up.

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Implications:

  • Ventricular tachycardia due to bundle branch reentry may be adenosine-sensitive.
  • Adenosine might treat catecholamine-mediated reentrant ventricular arrhythmias, not just triggered activity.