Unusual Cause of Bidirectional Ventricular Rhythm

Praloy Chakraborty; Hermohander Singh Isser; Sudheer Arava; Mona Bhatia; Kausik Mandal; Arshad Jahangir

doi:10.1016/j.jaccas.2019.05.018

Unusual Cause of Bidirectional Ventricular Rhythm

JACC Case Rep. 2019 Jun 19;1(1):21-26. doi: 10.1016/j.jaccas.2019.05.018. eCollection 2019 Jun.

Authors

Praloy Chakraborty¹, Hermohander Singh Isser², Sudheer Arava³, Mona Bhatia⁴, Kausik Mandal⁵, Arshad Jahangir⁶

Affiliations

¹ Department of Cardiac Electrophysiology, Toronto General Hospital, Toronto, Ontario, Canada.
² Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.
³ Department of Pathology, All India Institute of Medical Science, New Delhi, India.
⁴ Department of Radiology and Imaging, Fortis Escorts Heart Institute, New Delhi, India.
⁵ Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
⁶ Aurora Center for Advanced Atrial Fibrillation Therapies, Aurora Cardiovascular Services, Aurora Health Care, Milwaukee, Wisconsin.

Abstract

Bidirectional ventricular tachycardia (BDVT), a rare ventricular arrhythmia, is commonly caused by digitalis toxicity or channelopathies and is rarely caused by aconite toxicity, myocarditis, infarction, or sarcoidosis. This paper describes a patient with BDVT, recurrent syncope, myocardial disarray, and interstitial fibrosis on histology but normal results on echocardiography with variants in the TTN, KCNH2, and GATA4 genes. (Level of Difficulty: Advanced.).

Keywords: bidirectional ventricular tachycardia; sarcoidosis; ventricular arrhythmia; ventricular tachycardia; ventricular bigeminy.

Publication types

Case Reports