Zhang LY, Dong SJ, Yu HJ, Chu YJ. Ventricular tachycardia originating from the His bundle: A case report. World J Clin Cases 2021; 9(32): 10040-10045 [PMID: 34877348 DOI: 10.12998/wjcc.v9.i32.10040]
Corresponding Author of This Article
Ying-Jie Chu, MD, PhD, Chief Doctor, Professor, Department of Cardiology, Zhengzhou University People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou 450003, Henan Province, China. chuyingjie59@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Lu-Yao Zhang, Shu-Juan Dong, Ying-Jie Chu, Department of Cardiology, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Hai-Jia Yu, Department of Emergency, Zhengzhou University People’s Hospital, Zhengzhou 450003, Henan Province, China
Author contributions: Zhang LY performed the study, collected data, and drafted the manuscript; Dong SJ, Yu HJ and Chu YJ collected data, performed literature searches and interpreted the data; Chu YJ made critical revisions to the manuscript; all the authors have read and approved the version of the article presented for publication.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and the accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interests to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying-Jie Chu, MD, PhD, Chief Doctor, Professor, Department of Cardiology, Zhengzhou University People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou 450003, Henan Province, China. chuyingjie59@163.com
Received: July 6, 2021 Peer-review started: July 6, 2021 First decision: July 26, 2021 Revised: August 16, 2021 Accepted: September 19, 2021 Article in press: September 19, 2021 Published online: November 16, 2021 Processing time: 126 Days and 18.3 Hours
Abstract
BACKGROUND
Ventricular tachycardia (VT) commonly occurs among patients with heart failure and can even cause sudden cardiac death. VT originating from the His bundle branch has been rarely reported. We present the case of a patient with VT from the His bundle branch.
CASE SUMMARY
A 58-year-old female complained of paroxysmal palpitations and dizziness for approximately 6 mo. She had a history of fatty liver and cholecystitis, and carotid atherosclerosis could not be excluded from the ultrasound results. An evaluation of the electrocardiogram obtained after admission showed spontaneous conversion between two different morphologies. The possible electrophysiologic mechanism suggested that the dual-source VT originated from the same source, the His bundle branch. Finally, the His bundle branch was ablated, and a dual-chamber pacemaker was inserted into the patient’s heart. No further VT occurred during the 3-year follow-up after hospital discharge.
CONCLUSION
The diagnosis of VT originating from the His bundle is rare and difficult to establish. The results of this study showed VT originating from the His bundle based on a careful evaluation of the electrocardiogram, and the diagnosis was confirmed by an intracardiac electrophysiologic examination.
Core Tip: This case report involves ventricular tachycardia originating from the His bundle, which is very rare. The diagnosis of the originating site was based on a careful electrocardiogram analysis and physician clinical experience. This case report provides a reference for the clinical diagnosis of such cases.
