Alternating morphology ventricular tachycardia associated with stable coronary artery disease: A case report

J Electrocardiol. 2022 Mar-Apr:71:40-43. doi: 10.1016/j.jelectrocard.2022.01.001. Epub 2022 Jan 17.

Abstract

Bidirectional ventricular tachycardia (BVT) is part of the spectrum of polymorphic ventricular tachycardia (VT). This is a case report of a 59-year-old male with stable coronary artery disease and baseline normal left ventricular ejection fraction (LVEF) who was followed for high burden symptomatic monomorphic premature ventricular complexes (PVC). He was admitted for syncope. The ECG showed recurrent non-sustained alternating morphology and double cycle length VT runs associated with deterioration in LVEF but without coronary artery disease progression. The patient had a successful catheter ablation of two distinct left ventricular PVC focus. This is a rare ECG pattern of alternating morphology VT similar to a bidirectional VT.

Keywords: Alternating morphology ventricular tachycardia; Bidirectional ventricular tachycardia; Ischemic cardiomyopathy; Polymorphic ventricular tachycardia; Premature Ventricular Complex.

Publication types

  • Case Reports

MeSH terms

  • Catheter Ablation* / adverse effects
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / surgery
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Stroke Volume
  • Tachycardia
  • Tachycardia, Ventricular* / complications
  • Tachycardia, Ventricular* / diagnosis
  • Tachycardia, Ventricular* / surgery
  • Ventricular Function, Left
  • Ventricular Premature Complexes* / complications
  • Ventricular Premature Complexes* / diagnosis
  • Ventricular Premature Complexes* / surgery

Supplementary concepts

  • Bidirectional tachycardia