2014
DOI: 10.1161/circep.114.002112
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Idiopathic Accelerated Idioventricular Rhythm or Ventricular Tachycardia Originating From the Right Bundle Branch

Abstract: Background— Accelerated idioventricular rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arrhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arrhythmia. Methods and Results— Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the … Show more

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Cited by 20 publications
(26 citation statements)
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“…In addition, both VAs may exhibit the same electrocardiogram pattern with LBBB morphology, late precordial transition in leads V5-V6, rapid downstroke of the QRS complex in the precordial leads, and left superior frontal plane axis (similar to the type 1 VT in our case) 7, 8. Although we did not compare electroanatomic activation maps acquired during both VT types, several features support a rather distal RBB source.…”
Section: Discussionmentioning
confidence: 66%
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“…In addition, both VAs may exhibit the same electrocardiogram pattern with LBBB morphology, late precordial transition in leads V5-V6, rapid downstroke of the QRS complex in the precordial leads, and left superior frontal plane axis (similar to the type 1 VT in our case) 7, 8. Although we did not compare electroanatomic activation maps acquired during both VT types, several features support a rather distal RBB source.…”
Section: Discussionmentioning
confidence: 66%
“…Although we did not compare electroanatomic activation maps acquired during both VT types, several features support a rather distal RBB source. They include clinical manifestation as idioventricular rhythm or VT with chronotropic variability accelerating by physical exercise, stress of isoproterenol infusion (whereas previously described MB-related sources rather manifested as VPCs inducing ventricular fibrillation), spontaneous presence of proximal exit giving rise to the type 2 VT with right QRS axis deviation (which was not described in the MB-related VAs), and complete abolition of all VAs by septal ablation above/proximal to the MB insertion at a site with distal RBB potential accompanied by ablation-induced progression of incomplete into complete RBBB 7, 8. Furthermore, the MB length on intracardiac echocardiography (Figure 3) in relation to the sites of favorable pace mapping and the extent and location of the radiofrequency lesion did not support abolition of a pure MB-related source by targeting septal and free-wall MB insertions 7 …”
Section: Discussionmentioning
confidence: 96%
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