Alternating wide complex tachycardia after surgical aortic valve replacement

Douglas Darden; Michael Eskander; Gregory K Feld

doi:10.1016/j.ipej.2021.02.001

Alternating wide complex tachycardia after surgical aortic valve replacement

Indian Pacing Electrophysiol J. 2021 May-Jun;21(3):191-195. doi: 10.1016/j.ipej.2021.02.001. Epub 2021 Feb 6.

Authors

Douglas Darden¹, Michael Eskander², Gregory K Feld²

Affiliations

¹ Division of Cardiology, Department of Medicine, Cardiovascular Institute, University of California San Diego, United States. Electronic address: djdarden@ucsd.edu.
² Division of Cardiology, Department of Medicine, Cardiovascular Institute, University of California San Diego, United States.

Abstract

A 51-year-old male developed recurrent episodes of palpitations and pre-syncope after surgical aortic valve replacement. Electrocardiograms after surgery revealed a wide complex tachycardia with alternating left bundle branch and right bundle branch block morphologies. An electrophysiology study (EPS) demonstrated typical bundle branch reentry ventricular tachycardia (BBRVT) treated successfully with right bundle ablation. We demonstrate the key diagnostic features of BBRVT on EPS, describe the circuit of BBRVT with explanation of the HV pseudointerval, and highlight the association of BBRVT and valve replacement.

Keywords: Aortic valve replacement; Bundle branch reentry; Ventricular tachycardia.

Publication types

Case Reports