This case demonstrates that pleomorphic ventricular tachycardia can arise from a single reentry circuit with conduction reversal.
Alerts electrophysiologists to single-circuit pleomorphism; hypothesis-generating and should not yet change ablation practice.
A case is presented of a patient with incessant ventricular tachycardia of left bundle branch block morphology. Endocardial mapping revealed the site of earliest activation during tachycardia to be the proximal right ventricular septum. Pacing at this site elicited the clinical tachycardia, whereas pacing at the proximal left ventricular septum induced a right bundle branch block morphology identical to that of a previously recorded spontaneous ventricular tachycardia. Electrophysiological evidence is given that both types of tachycardia originate from a single reentry circuit located in the proximal ventricular septum in which the reentrant wavefront may travel either orthodromically (during spontaneous tachycardia and right ventricular pacing) or antidromically (during left ventricular pacing).
No takes yet. Share an insight, caveat, or question.
Kück et al. (1989) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: