Bundle Branch Reentrant Ventricular Tachycardia

Bundle branch reentrant (BBR) tachycardia is an uncommon form of ventricular tachycardia (VT) incorporating both bundle branches into the reentry circuit. The arrhythmia is usually seen in patients with an acquired heart disease and significant conduction system impairment, although patients with st...

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Main Authors:	Mazur, Alexander, Kusniec, Jairo, Strasberg, Boris
Format:	Online
Language:	English
Published:	Indian Pacing and Electrophysiology Group 2005
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502081/

id	pubmed-1502081
recordtype	oai_dc
spelling	pubmed-15020812006-08-29 Bundle Branch Reentrant Ventricular Tachycardia Mazur, Alexander Kusniec, Jairo Strasberg, Boris Reviews Bundle branch reentrant (BBR) tachycardia is an uncommon form of ventricular tachycardia (VT) incorporating both bundle branches into the reentry circuit. The arrhythmia is usually seen in patients with an acquired heart disease and significant conduction system impairment, although patients with structurally normal heart have been described. Surface ECG in sinus rhythm (SR) characteristically shows intraventricular conduction defects. Patients typically present with presyncope, syncope or sudden death because of VT with fast rates frequently above 200 beats per minute. The QRS morphology during VT is a typical bundle branch block pattern, usually left bundle branch block, and may be identical to that in SR. Prolonged His-ventricular (H-V) interval in SR is found in the majority of patients with BBR VT, although some patients may have the H-V interval within normal limits. The diagnosis of BBR VT is based on electrophysiological findings and pacing maneuvers that prove participation of the His- Purkinje system in the tachycardia mechanism. Radiofrequency catheter ablation of a bundle branch can cure BBR VT and is currently regarded as the first line therapy. The technique of choice is ablation of the right bundle. The reported incidence of clinically significant conduction system impairment requiring implantation of a permanent pacemaker varies from 0% to 30%. Long-term outcome depends on the underlying cardiac disease. Patients with poor systolic left ventricular function are at risk of sudden death or death from progressive heart failure despite successful BBR VT ablation and should be considered for an implantable cardiovertor-defibrillator. Indian Pacing and Electrophysiology Group 2005-04-01 /pmc/articles/PMC1502081/ /pubmed/16943949 Text en Copyright: © 2005 Mazur et al. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Mazur, Alexander Kusniec, Jairo Strasberg, Boris
spellingShingle	Mazur, Alexander Kusniec, Jairo Strasberg, Boris Bundle Branch Reentrant Ventricular Tachycardia
author_facet	Mazur, Alexander Kusniec, Jairo Strasberg, Boris
author_sort	Mazur, Alexander
title	Bundle Branch Reentrant Ventricular Tachycardia
title_short	Bundle Branch Reentrant Ventricular Tachycardia
title_full	Bundle Branch Reentrant Ventricular Tachycardia
title_fullStr	Bundle Branch Reentrant Ventricular Tachycardia
title_full_unstemmed	Bundle Branch Reentrant Ventricular Tachycardia
title_sort	bundle branch reentrant ventricular tachycardia
description	Bundle branch reentrant (BBR) tachycardia is an uncommon form of ventricular tachycardia (VT) incorporating both bundle branches into the reentry circuit. The arrhythmia is usually seen in patients with an acquired heart disease and significant conduction system impairment, although patients with structurally normal heart have been described. Surface ECG in sinus rhythm (SR) characteristically shows intraventricular conduction defects. Patients typically present with presyncope, syncope or sudden death because of VT with fast rates frequently above 200 beats per minute. The QRS morphology during VT is a typical bundle branch block pattern, usually left bundle branch block, and may be identical to that in SR. Prolonged His-ventricular (H-V) interval in SR is found in the majority of patients with BBR VT, although some patients may have the H-V interval within normal limits. The diagnosis of BBR VT is based on electrophysiological findings and pacing maneuvers that prove participation of the His- Purkinje system in the tachycardia mechanism. Radiofrequency catheter ablation of a bundle branch can cure BBR VT and is currently regarded as the first line therapy. The technique of choice is ablation of the right bundle. The reported incidence of clinically significant conduction system impairment requiring implantation of a permanent pacemaker varies from 0% to 30%. Long-term outcome depends on the underlying cardiac disease. Patients with poor systolic left ventricular function are at risk of sudden death or death from progressive heart failure despite successful BBR VT ablation and should be considered for an implantable cardiovertor-defibrillator.
publisher	Indian Pacing and Electrophysiology Group
publishDate	2005
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502081/
_version_	1611384615818231808

Bundle Branch Reentrant Ventricular Tachycardia

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