Bidirectional Ventricular Tachycardia Due to a Mixture of Focal Fascicular Firing and Reentry. [Review]

MedStar author(s):
Citation: Cardiac electrophysiology clinics. 8(4):753-764, 2016 DecPMID: 27837895Institution: MedStar Health Research InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Electrocardiography | *Heart Conduction System/pp [Physiopathology] | *Tachycardia | Aged | Bundle-Branch Block | Humans | Hyperlipidemias | Male | Myocardial IschemiaYear: 2016ISSN:
  • 1877-9182
Name of journal: Cardiac electrophysiology clinicsAbstract: Bidirectional ventricular tachycardia (BDVT) is a well-known phenomenon since it was first described in 1922. Various mechanisms have been proposed for BDVT, including digitalis toxicity, hypokalemia, Anderson-Tawil syndrome, acute myocarditis, and catecholaminergic polymorphic ventricular tachycardia. It is characterized by rapid, wide complex electrocardiogram pattern with alternating QRS morphology and axis. The alternation of the QRS is usually right bundle branch block with 180degree swings in the frontal plane axis or, less commonly, alternation of right bundle branch and left bundle branch forms. Most of the proposed mechanisms involve triggered activity or enhanced automaticity. We describe a unique BDVT, with characteristics of both re-entry and triggered activity, which terminated with a focal Rf lesion.Copyright � 2016 Elsevier Inc. All rights reserved.All authors: Durrani SA, Scheinman M, Sung RFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-24
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Journal Article MedStar Authors Catalog Article 27837895 Available 27837895

Bidirectional ventricular tachycardia (BDVT) is a well-known phenomenon since it was first described in 1922. Various mechanisms have been proposed for BDVT, including digitalis toxicity, hypokalemia, Anderson-Tawil syndrome, acute myocarditis, and catecholaminergic polymorphic ventricular tachycardia. It is characterized by rapid, wide complex electrocardiogram pattern with alternating QRS morphology and axis. The alternation of the QRS is usually right bundle branch block with 180degree swings in the frontal plane axis or, less commonly, alternation of right bundle branch and left bundle branch forms. Most of the proposed mechanisms involve triggered activity or enhanced automaticity. We describe a unique BDVT, with characteristics of both re-entry and triggered activity, which terminated with a focal Rf lesion.

Copyright � 2016 Elsevier Inc. All rights reserved.

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