Two apparently remote types of ventricular tachycardia from a single right bundle branch focal source

Josiek, Jaromír; Januška, Jaroslav; Fiala, Martin

doi:10.1016/j.hrcr.2017.01.011

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2021

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“…Right bundle branch ventricular arrhythmias (RBB-VA) are rare arrhythmias with various clinical presentations and suboptimal responses to medical therapy. 1 Only sporadic case reports and small series have reported on catheter ablation of RBB-VA. [1][2][3][4][5][6][7][8][9][10][11] A systematic analysis of electrophysiologic properties, conduction block, and catheter ablation of this rare arrhythmia is incomplete.…”

Section: Introductionmentioning

confidence: 99%

Unusual right bundle branch origin ventricular arrhythmias: Electroanatomical insights for successful catheter ablation

Ehdaie

Liu

Namazi

et al. 2021

Pacing Clinical Electrophis

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Three patients with RBB-VA were identified, one with PVC (No. 1), and two with accelerated idioventricular rhythm (AIVR) (No. 2 and 3) that were all symptomatic with palpitations and refractory to medical therapy. Patient No. 2 had reduced LVEF of 20% secondary to incessant RBB-VA. QRS morphologies and HV intervalsQRS morphology (QRSm) and QRS duration (QRSd) of RBB-VA varied across all patients (Figures 1-3). AIVR demonstrated widely variable cycle lengths and was suppressed by atrial pacing. One AIVR was induced only with IV metoprolol (No. 3). HV intervals were within normal limits during sinus rhythm and varied during RBB-VA among the two patients with recordable HV intervals (No. 2 and 3).

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