Key result
Electrophysiological study and malignancy reassessment in a 16-year-old male with bidirectional ventricular tachycardia revealed a single septal focus caused by a 4 mm metastatic cardiac nodule.
Case Report (n=1)
This case highlights that bidirectional ventricular tachycardia can be caused by cardiac metastases at the interventricular septum acting as a single focus with two exit sites.
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Consider cardiac metastases in adolescents with bidirectional VT; extends the differential but leaves open prospective validation.
A case is reported of bidirectional ventricular tachycardia and syncope in a 16-year-old male with a previous history of a paratesticular rhabdomyosarcoma that achieved complete remission with treatment. At the electrophysiological study, frequent ectopy of both right and left bundle branch block pattern were present, with runs of monomorphic and bidirectional VT alternating the two morphologies. The study suggested a single focus at the interventricular septum with two exit sites, depolarizing the right and left ventricle in an alternate fashion. Reassessment of the malignancy status showed multiple cardiac metastases with a 4 mm nodule at the interventricular septum.
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Dorfman et al. (2006) conducted a case report in Bidirectional ventricular tachycardia and syncope with metastatic cardiac tumors (n=1). Electrophysiological study and malignancy reassessment was evaluated on Identification of VT mechanism and etiology. Electrophysiological study and malignancy reassessment in a 16-year-old male with bidirectional ventricular tachycardia revealed a single septal focus caused by a 4 mm metastatic cardiac nodule.
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