Journal of Electrocardiology
Volume 43, Issue 5 , Pages 415-417, September 2010

Repetitive polymorphic ventricular tachycardia initiated by phase 4 block in the His-Purkinje system☆

  • Jose' Dizon, MD

      Affiliations

    • Corresponding Author InformationCorresponding author. Division of Cardiology, Department of Medicine, Columbia University Medical Center Columbia University, 222 Westchester Ave., White Plains, NY 10604, USA.
    • ,
  • Daniel Wang, MD
    • ,
  • Alan Vainrib, MD

Division of Cardiology, Department of Medicine, Columbia University Medical Center Columbia University, New York, NY, USA

Received 3 November 2009 published online 25 January 2010.

Abstract 

We report a case of a patient who developed repetitive episodes of polymorphic ventricular tachycardia with a stereotypical pattern of initiation. A premature atrial complex would result in a brief pause followed by left bundle branch block aberrancy. Ventricular bigeminy would ensue followed by episodes of polymorphic ventricular tachycardia, some requiring cardioversion. We postulate that delay within the His-Purkinje system initiated by phase 4 block was proarrhythmic in this patient.

Keywords: Phase 4 block, Ventricular tachycardia, Left bundle branch block

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☆ No conflict of interest or financial support to disclose.

PII: S0022-0736(09)00638-4

doi:10.1016/j.jelectrocard.2009.12.011

Journal of Electrocardiology
Volume 43, Issue 5 , Pages 415-417, September 2010

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