Bundle branch reentry: A rare mechanism of ventricular tachycardia in endomyocardial fibrosis, without ventricular dilation

Prabhu, Mukund A.; Bv, Srinivas; Thajudeen, Anees; Namboodiri, Narayanan

doi:10.1016/j.ihj.2016.02.005

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…However, ventricular histopathology demonstrates increased type I collagen deposition, subendocardial infarction, and fibrosis which could explain why EMF can trigger ventricular arrythmias. Interestingly, in spite of the fibrous involvement of the myocardium in EMF, VT is extremely uncommon and only a few case reports exist [1, 2, 4]. The geographical distribution of the disease may be contributing as many of the cases are not diagnosed, and even if ventricular arrythmias occur, it is not reported.…”

Section: Discussionmentioning

confidence: 99%

“…The geographical distribution of the disease may be contributing as many of the cases are not diagnosed, and even if ventricular arrythmias occur, it is not reported. Prabhu et al proposed that the involvement of a conducting system of the heart by the fibrotic process might result in bundle branch re-entry that can explain such a peculiar presentation [4]. Differential diagnosis of such condition includes idiopathic ventricular tachycardia, arrhythmogenic right ventricular dysplasia (ARVC), or right ventricular dilated cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

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Endomyocardial fibrosis presented by ventricular tachycardia: case report

et al. 2019

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BackgroundEndomyocardial fibrosis (EMF) is a form of restrictive cardiomyopathy that is diagnosed mainly in children and young adults and is geographically found in Africa, Latin America, and Asia. It is a condition with high morbidity and mortality, unknown etiology, and no definitive treatment. Although its main clinical presentation is congestive heart failure with or without related supraventricular arrhythmia like atrial fibrillation, it very rarely presents with ventricular arrhythmias and tachycardias (VA, VT).Case presentationWe report a case of right ventricular (RV) EMF presented with recurrent attacks of hemodynamically unstable VT that required direct current (DC) cardioversion. The diagnosis was suspected by transthoracic echocardiography (TTE) and established by cardiac magnetic resonance (CMR). The patient underwent implantable cardioverter–defibrillator (ICD) implantation for secondary prevention of VT, and he was discharged safely on antiarrhythmic drugs with regular follow-up visits.ConclusionEMF presenting with VT are quite rare and to the best of our knowledge, our case is the fourth case in the literature to report VT as a clinical presentation of EMF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endomyocardial fibrosis presented by ventricular tachycardia: case report

et al. 2019

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“…8 out of 12 courses of therapy showed ventricular premature contractions. [5] Because of non sustained ventricular tachycardia [6] , treatment with antiarrhythmic agents was given for 4 patients. Lengfelder et al described arsenic trioxide as very potent and first line agent in treatment of APL.…”

Section: Ecg Monitoring Recommendations and Precautionsmentioning

confidence: 99%

Arsenic trioxide-induced QT interval prolongation: A case report

Mohan¹,

Prabhu²,

Reghu³

2017

Natl J Physiol Pharm Pharmacol

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QT prolongation refers to the prolonged QT interval in electrocardiography (ECG) which can even lead to life-threatening events such as ventricular arrhythmias, torsades de pointes, etc., several drugs can cause QT prolongation which includes sotalol, quinidine, arsenic, disopyramide, procainamide, amiodarone, haloperidol, etc., Arsenic trioxide (ATO) is used as an effective treatment option in promyelocytic leukemia (PML). Acute myeloid leukemia (AML) is a cancer that affects the blood and bone marrow. Acute promyelocytic leukemia (APL) is the M3 subtype of AML that affects mainly the white blood cells. In APL, immature granulocytes accumulate abnormally to form promyelocytes. ATO helps in the apoptosis of these cancerous promyelocytic cells. In patients on arsenic therapy, ECGs must be monitored to ensure QT prolongation as it a major side effect of the drug. Here is the case of a 58-year-old female patient and was newly diagnosed with APL. She developed QT prolongation with arsenic therapy. Other confounding factors such as electrolytes and presence of other QT-prolonging drugs were also corrected.

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