His Bundle Electrocardiography during Bidirectional Tachycardia
Key result
His bundle electrocardiography favored a ventricular origin for digitalis-induced bidirectional tachycardia due to the absence of a His spike preceding the earliest onset of ventricular activation.
Why the study?
Does His bundle electrocardiography help determine the origin of digitalis-induced bidirectional tachycardia?
Population
1 patient with digitalis-induced bidirectional tachycardia
Design
Case_report
Authors
Discussion
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Implication
Hypothesis-generating for ventricular origin in digitalis-induced bidirectional tachycardia; does not support practice change without further evidence.
Key Points
- To investigate the electrocardiographic characteristics of His bundle activity during bidirectional tachycardia in a patient affected by digitalis.
- Performed His bundle electrocardiography in a patient with tachycardia.
- Analyzed cycle lengths and responses to carotid sinus massage.
- Identified presence of fusion and capture QRS complexes.
- Absence of His spike preceding ventricular activation during bidirectional tachycardia.
- Constant H-V interval of 35 msec for normal complexes.
- Findings suggest ventricular origin for tachycardia.
Study Design
Type
Case Report (n=1)
Structured PICO
Does His bundle electrocardiography help determine the origin of digitalis-induced bidirectional tachycardia?
P
Population
A single patient with digitalis-induced bidirectional tachycardia undergoing His bundle electrocardiography.
E
Exposure
His bundle electrocardiography
O
Outcome
Origin of the bidirectional tachycardiasurrogate
His bundle electrocardiography demonstrated a ventricular origin for digitalis-induced bidirectional tachycardia in this patient.
Cite This Study
Morris et al. (1973) conducted a case report in Digitalis-induced bidirectional tachycardia (n=1). His bundle electrocardiography was evaluated on Origin of bidirectional tachycardia. His bundle electrocardiography favored a ventricular origin for digitalis-induced bidirectional tachycardia due to the absence of a His spike preceding the earliest onset of ventricular activation.