Bundle Branch Reentrant Ventricular Tachycardia in a Patient with the Brugada Electrocardiographic Pattern

Abstract

A 55-year-old, previously healthy man presented with an episode of wide QRS tachycardia that had left bundle branch morphology and left superior axis. His electrocardiogram in sinus rhythm showed characteristic Brugada pattern with coved type ST-segment (J-point) elevation in leads V1-V2, mild QRS widening of 110 ms, and left axis deviation. The mechanism of the tachycardia was shown to be bundle branch reentry. Baseline H-V interval of 68 ms additionally lengthened to 119 ms after intravenous procainamide administration indicating significant conduction system disease. The tachycardia was no longer inducible after successful ablation of the right bundle branch.

Bundle branch reentrant ventricular tachycardia after transcatheter aortic valve replacement

“…BBR-VT has been described secondary to flecainide use, 7 Brugada pattern, 8 and AV block 9 . Conduction abnormalities are common in valvular heart disease owing to associated ventricular dilatation and calcification of the valvular annuli 10 .…”

“…Most of the cases of BBR-VT are seen in patients with structural heart disease, but multiple case reports exist in the literature in patients with structurally normal hearts. 6 BBR-VT has been described secondary to flecainide use, 7 Brugada pattern, 8 and AV block. 9 Conduction abnormalities are common in valvular heart disease owing to associated ventricular dilatation and calcification of the valvular annuli.…”

Syncopal monomorphic ventricular tachycardia with pleomorphism, sensitive to antitachycardia pacing in a patient with Brugada syndrome

“…Syncopal attacks in the Brugada syndrome are typically related to polymorphic ventricular tachycardia, 1 but cases of monomorphic ventricular tachycardia have also been reported in the literature. [2][3][4][5] In this patient, episodes of monomorphic regular ventricular tachycardia, with pleomorphism and sensitive to ventricular stimulation, were the cause of syncopal episodes. These arrhythmias could not be induced during the electrophysiological study, but were detected during the follow-up with the use of an ILR.…”

Two Forms of Monomorphic Ventricular Tachycardia in a Patient with Brugada Syndrome

“…Brugada syndrome (BrS) is an arrhythmogenic disease that causes sudden cardiac death mainly due to ventricular fibrillation (VF) or polymorphic ventricular tachycardia (VT). However, rare cases of monomorphic VT arising from a focal origin, such as the outflow tract, or due to re-entry involving the conduction system have also been reported (1,2). Thus far, there have been no case reports of patients with BrS combined with multiple forms of monomorphic VT.…”