Open AccessDemonstration of a hidden interaction between the aortomitral continuity and the conduction system in a case of idiopathic left ventricular outflow tract ventricular tachycardia
Author(s) -
Mizobuchi Masahiro,
Enjoji Yoshihisa
Publication year - 2015
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2014.10.004
Subject(s) - bigeminy , medicine , cardiology , qrs complex , sinus rhythm , ventricular tachycardia , left bundle branch block , right bundle branch block , catheter ablation , ventricular outflow tract , ablation , electrocardiography , atrial fibrillation , heart failure
We describe a case of idiopathic left ventricular outflow ventricular tachycardia. Monomorphic ventricular arrhythmia (VA) with a right bundle branch block morphology and an inferior axis was induced through exercise or isoproterenol infusion. During VA bigeminy, a spiked presystolic potential (PP) preceding the VA with a qrS pattern in the unipolar electrogram was recorded at the aortomitral continuity (AMC). Radiofrequency catheter ablation eliminated the VA despite the persistence of sinus‐PP bigeminy. Furthermore, these PP rates were dependent on the preceding sinus rhythm rates. The present case suggests a hidden interaction between the AMC and the conduction system.