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Bidirectional Tachycardia. Mechanism Derived from Intracardiac Recordings and Programmed Electrical Stimulation
Author(s) -
LEVY SAMUEL,
HILAIRE JEAN,
CLEMENTY JACQUES,
BARTOLIN ROBERT,
BESSE PIERRE,
GERARD RAYMOND,
BRICAUD HENRI
Publication year - 1982
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1982.tb02298.x
Subject(s) - medicine , intracardiac injection , tachycardia , stimulation , mechanism (biology) , cardiology , philosophy , epistemology
His bundle recordings and programmed electrical stimulation were performed in a 70‐year‐old woman with bidirectional tachycardia; the recordings demonstrated the infra‐Hissian origin of the tachycardia. Occurrence of the His deflection slightly after the onset of ventricular depolarization suggested that the origin of the tachycardia was located near the His bundle bifurcation. Recording of three atrial sites during tachycardia allowed the study of retrograde atrial activation. Two sets of fairly constant and alternating VA intervals were recorded. This fact is consistent with two ventricular circuits used alternatively. The tachycardia could also be interrupted with a single atrial or ventricular premature beat It is postulated that the tachycardia is due to macroreentry involving the two fascicles of the left branch. This study suggests that reentry may be a possible mechanism in some cases of bidirectional tachycardia. (PACE, Vol. 5, September‐October, 1982)