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Verapamil-sensitive left posterior fascicular ventricular tachycardia after myocardial infarction

  • Bipinpreet Nagra
  • Zhengou Liu
  • Rohit Mehta
  • David Hart
  • Bharat K. Kantharia
CASE REPORT

Abstract

Verapamil-sensitive fascicular ventricular tachycardia (VT) of right bundle branch block (RBBB) and superior axis pattern is typically seen in young patients with structurally normal hearts and considered “idiopathic”. Recently, involvement of the Purkinje system in post-infarction monomorphic VT that mimics such idiopathic fascicular VT has been described. In this report we describe a case of a patient who following myocardial infarction developed left posterior fascicular Purkinje reentrant VT that was sensitive to verapamil. The VT was successfully treated by radiofrequency ablation guided by three dimensional electroanatomical CARTO™ mapping. Our case highlights that involvement of Purkinje fibers should be considered in post infarction patients with VT of narrow QRS duration, RBBB morphology and superior axis. Recognition of such VT is clinically important, as this arrhythmia is amenable to curative catheter ablation.

Keywords

Ventricular tachycardia Verapamil-sensitive fascicular ventricular tachycardia Coronary artery disease Electroanatomical CARTO mapping Radiofrequency ablation 

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Bipinpreet Nagra
    • 1
  • Zhengou Liu
    • 1
  • Rohit Mehta
    • 1
  • David Hart
    • 1
  • Bharat K. Kantharia
    • 1
    • 2
  1. 1.Division of Cardiac ElectrophysiologyThe Ohio State University Medical CenterColumbusUSA
  2. 2.Division of CardiologyThe University of Texas-HSC at HoustonHoustonUSA

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