Key result
AF ablation completely suppresses bundle branch re-entrant VT triggered exclusively by atrial fibrillation.
Why the study?
The optimal therapeutic strategy for bundle branch re-entrant ventricular tachycardia triggered exclusively by atrial fibrillation is unclear.
Does atrial fibrillation ablation prevent bundle branch re-entrant ventricular tachycardia when triggered exclusively by atrial fibrillation?
Case Report (n=1)
Does atrial fibrillation ablation prevent bundle branch re-entrant ventricular tachycardia when triggered exclusively by atrial fibrillation?
Atrial fibrillation ablation may be an effective therapeutic strategy for suppressing bundle branch re-entrant ventricular tachycardia when it is triggered exclusively by atrial fibrillation.
AF ablation may suffice for BBR-VT triggered solely by AF; hypothesis-generating and should not yet alter right bundle ablation practice.
BACKGROUND: with the right bundle branch typically targeted for ablation. CASE SUMMARY: A 68-year-old man with prior myocardial infarction presented with recurrent ventricular tachycardia (VT). Electrophysiological study suggested BBR-VT. VT was inducible only by atrial pacing and occurred clinically exclusively during atrial fibrillation (AF). Therefore, AF ablation alone was performed, resulting in complete suppression of VT. DISCUSSION: When BBR-VT is triggered exclusively by AF, AF ablation may be an effective therapeutic strategy. TAKE-HOME MESSAGES: In patients with BBR-VT that is triggered exclusively by atrial fibrillation or atrial pacing, elimination of the triggering atrial arrhythmia may suppress VT without the need for bundle branch ablation. Even when AF ablation is effective, implantable cardioverter-defibrillator implantation and careful long-term follow-up remain essential because recurrence of atrial tachyarrhythmias may precipitate VT recurrence.
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Sakai et al. (2026) conducted a case report in Bundle branch re-entrant ventricular tachycardia (BBR-VT) triggered by atrial fibrillation (n=1). Atrial fibrillation ablation was evaluated on Complete suppression of ventricular tachycardia. Atrial fibrillation ablation completely suppressed bundle branch re-entrant ventricular tachycardia in a patient whose VT was triggered exclusively by atrial fibrillation.
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