Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.10040
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
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.
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.
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.