Unusual Cause of Bidirectional Ventricular Rhythm

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 bigeminy
• ventricular tachycardia