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Bundle branch reentrant ventricular tachycardia: review and case presentation

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Abstract

Bundle branch reentrant ventricular tachycardia (BBRVT) is characterized by a unique, fast (200–300 beats/min), monomorphic wide complex tachycardia (WCT) associated with syncope, hemodynamic compromise, and cardiac arrest. It is challenging to diagnose, requiring a His bundle recording and specific pacing maneuvers. The overall incidence has been reported to be up to 20% among patients with non-ischemic cardiomyopathy (NICM) undergoing electrophysiologic studies. We report a case of BBRVT in a patient with ischemic cardiomyopathy (ICM) presenting as a WCT with recurrent implantable-cardioverter-defibrillator (ICD) shocks. We describe all the characteristic features of BBRVT and discuss its differential. We also discuss the role of ablation for this condition.

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Authors and Affiliations

  1. Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA

    Jorge Romero, Michael Grushko, David Briceno, Roberto Cerrud-Rodriguez, Renato Quispe, Vito Grupposo & Luigi Di Biase

  2. Penn Heart and Vascular Center, Perelman Center for Advanced Medicine, East Pavilion, 2nd Floor, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Pasquale Santangeli

  3. Canberra Hospital, Australian National University, Canberra, Australia

    Rajeev K. Pathak

Authors
  1. Jorge Romero
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  2. Pasquale Santangeli
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  3. Rajeev K. Pathak
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  4. Michael Grushko
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  5. David Briceno
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  6. Roberto Cerrud-Rodriguez
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  7. Renato Quispe
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  8. Vito Grupposo
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  9. Luigi Di Biase
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Correspondence to Luigi Di Biase.

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Conflict of interest

Dr. Di Biase is a consultant for Stereotaxis, Biosense Webster, Boston Scientific, and St. Jude Medical. Dr. Di Biase received speaker honoraria/travel from Medtronic, Janssen, Bristol Meyers Squibb, EPiEP, and Biotronik. Vito Grupposo is a clinical account specialist at Biosense Webster. The other authors have no disclosures. Rajeev K. Pathak is supported by an Early Career Fellowship from the National Health and Medical Research Council of Australia.

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Romero, J., Santangeli, P., Pathak, R.K. et al. Bundle branch reentrant ventricular tachycardia: review and case presentation. J Interv Card Electrophysiol 52, 385–393 (2018). https://doi.org/10.1007/s10840-018-0434-z

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  • DOI: https://doi.org/10.1007/s10840-018-0434-z

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