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Idiopathic Left Ventricular Tachycardia with Left and Right Bundle Branch Block Configurations
Author(s) -
ZIVIN ADAM,
GOYAL RAJIVA,
DAOUD EMILE,
MAN K. CHING,
STRICKBERGER S. ADAM,
MORADY FRED
Publication year - 1997
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1997.tb00810.x
Subject(s) - medicine , right bundle branch block , cardiology , left axis deviation , left bundle branch block , tachycardia , ventricular tachycardia , fascicle , qrs complex , electrocardiography , bundle branch block , anatomy , heart failure
Fascicular Tachycardia. Introduction : Idiopathic left ventricular tachycardia typically has a right bundle branch block configuration. The purpose of this case report is to demonstrate that idiopathic ventricular tachycardia arising in or near the left posterior fascicle also may have a left bundle branch block configuration. Methods and Results : A 27‐year‐old woman underwent an electrophysiologic procedure because of recurrent, verapamil‐responsive, wide QRS complex tachycardia. Two types of ventricular tachycardia (cycle lengths 330 to 340 msec) were reproducibly inducible, one with a right bundle branch block configuration and left‐axis deviation that had been documented clinically, and the other with a left bundle branch block configuration and axis of zero. A Purkinje potential recorded at the junction of the left ventricular mid‐septum and inferior wall preceded the ventricular complex by 40 msec in both tachycardias. A single application of ra‐diofrequency energy at this site successfully ablated both ventricular tachycardias. Conclusion : The findings of this case report demonstrate that idiopathic ventricular tachycardia arising in or near the left posterior fascicle may have a left bundle branch block configuration