Bidirectional Tachycardia: Two Cases and a Review

Beyond the Pleasure Principle - Fatal Cardiac Arrhythmias After Ingestion of an Herbal Medication

“…Postulated mechanisms suggest a single focus in the proximal His bundle or bundle branches with alternating left fascicular block, or single or double foci in the distal His Purkinje system as well as reentry. 3 Management of aconite poisoning is generally supportive. No specific antidote exists.…”

“…Bi-directional ventricular tachycardia is an uncommon and unique arrhythmia with extremely limited differential diagnoses. 3 We present a case of bi-directional ventricular tachycardia and refractory bradyarrhythmia occurring after acute ingestion of large quantity of a multi-herb compound with a devastating clinical course.…”

Alternating Ventricular Complexes After Overdose From an Herbal Medication

“…Bidirectional VT has also been observed in other clinical settings in which patients have structurally normal hearts, such as catecholaminergic polymorphic VT and hyperkalemic or hypokalemic periodic paralysis. 9 Treatment of aconite poisoning is largely supportive. In one retrospective review of the literature, Coulson et al 10 found flecainide or amiodarone to be associated with a greater return to sinus rhythm than lidocaine or cardioversion.…”

Swinging rhythms

“…In most cases of BVT, an aetiology that causes triggered activity is present [ 1 ]. In this case, there is no evidence for digoxin toxicity, electrolyte disturbances, myocarditis or other aetiologies that have previously been associated with BVT.…”