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Bundle-branch reentry ventricular tachycardia after transcatheter aortic valve replacement.

de la Rosa Riestra A, Rubio Caballero JA, Freites Estévez A, Alonso Belló J, Botas Rodríguez J - Indian Pacing Electrophysiol J (2016)

Bottom Line: The patient was wearing an ECG holter monitor that day, which showed a wide QRS complex tachycardia of 300 beats per minute.Radio-frequency was applied on the right-bundle branch.Twelve months later, the patient has remained asymptomatic.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.

ABSTRACT
An 83-year-old male suffering from severe symptomatic aortic valve stenosis received an implant of a biological aortic prosthesis through the femoral artery without complications. Seven days after dischargement he experienced a syncope. The patient was wearing an ECG holter monitor that day, which showed a wide QRS complex tachycardia of 300 beats per minute. The electrophysiological study revealed a bundle-branch reentry ventricular tachycardia as the cause of the syncope. Radio-frequency was applied on the right-bundle branch. Twelve months later, the patient has remained asymptomatic.

No MeSH data available.


Related in: MedlinePlus

A. ECG during the electrophysiological study: 300 bpm ventricular tachycardia with a left-bundled branch block. B: intracardiac recordings from high right atrium (HRA), His bundle area and right ventricle apex (RVA). Pacing from RVA in VT. The post pacing interval was +20 ms. C ECG after radio-frequency was applied on the right-bundle. Branch.
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fig2: A. ECG during the electrophysiological study: 300 bpm ventricular tachycardia with a left-bundled branch block. B: intracardiac recordings from high right atrium (HRA), His bundle area and right ventricle apex (RVA). Pacing from RVA in VT. The post pacing interval was +20 ms. C ECG after radio-frequency was applied on the right-bundle. Branch.

Mentions: An electrophysiological study was performed, which revealed an HV interval of 64 ms. We induced, through ventricular stimulation, a 300 bpm ventricular tachycardia (Fig. 2A) with a left-bundled branch block and left axis, with similar morphology to the syncope-registered ECG. We were unable to register the His during the tachycardia. The post pacing interval after entrainment by right ventricular apex stimulation was +20 ms (Fig. 2B). The conclusion was that the cause of the syncope was due to a bundle-branch reentry. Radio-frequency was applied on the right-bundle branch, with a QRS widening from 130 ms to 150 ms (Fig. 2C). It was afterwards not possible to induce the tachycardia. The HV interval after the ablation was of 67 ms, and the Wenckebach AV point was 180 bpm. Twelve months later, the patient has remained asymptomatic.


Bundle-branch reentry ventricular tachycardia after transcatheter aortic valve replacement.

de la Rosa Riestra A, Rubio Caballero JA, Freites Estévez A, Alonso Belló J, Botas Rodríguez J - Indian Pacing Electrophysiol J (2016)

A. ECG during the electrophysiological study: 300 bpm ventricular tachycardia with a left-bundled branch block. B: intracardiac recordings from high right atrium (HRA), His bundle area and right ventricle apex (RVA). Pacing from RVA in VT. The post pacing interval was +20 ms. C ECG after radio-frequency was applied on the right-bundle. Branch.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834427&req=5

fig2: A. ECG during the electrophysiological study: 300 bpm ventricular tachycardia with a left-bundled branch block. B: intracardiac recordings from high right atrium (HRA), His bundle area and right ventricle apex (RVA). Pacing from RVA in VT. The post pacing interval was +20 ms. C ECG after radio-frequency was applied on the right-bundle. Branch.
Mentions: An electrophysiological study was performed, which revealed an HV interval of 64 ms. We induced, through ventricular stimulation, a 300 bpm ventricular tachycardia (Fig. 2A) with a left-bundled branch block and left axis, with similar morphology to the syncope-registered ECG. We were unable to register the His during the tachycardia. The post pacing interval after entrainment by right ventricular apex stimulation was +20 ms (Fig. 2B). The conclusion was that the cause of the syncope was due to a bundle-branch reentry. Radio-frequency was applied on the right-bundle branch, with a QRS widening from 130 ms to 150 ms (Fig. 2C). It was afterwards not possible to induce the tachycardia. The HV interval after the ablation was of 67 ms, and the Wenckebach AV point was 180 bpm. Twelve months later, the patient has remained asymptomatic.

Bottom Line: The patient was wearing an ECG holter monitor that day, which showed a wide QRS complex tachycardia of 300 beats per minute.Radio-frequency was applied on the right-bundle branch.Twelve months later, the patient has remained asymptomatic.

View Article: PubMed Central - PubMed

Affiliation: Cardiology Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.

ABSTRACT
An 83-year-old male suffering from severe symptomatic aortic valve stenosis received an implant of a biological aortic prosthesis through the femoral artery without complications. Seven days after dischargement he experienced a syncope. The patient was wearing an ECG holter monitor that day, which showed a wide QRS complex tachycardia of 300 beats per minute. The electrophysiological study revealed a bundle-branch reentry ventricular tachycardia as the cause of the syncope. Radio-frequency was applied on the right-bundle branch. Twelve months later, the patient has remained asymptomatic.

No MeSH data available.


Related in: MedlinePlus