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VT Storm Acute Management — EECC MCQ

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HardHeart FailureVT Storm Acute ManagementEECC

A patient with dilated cardiomyopathy and marked His–Purkinje disease has recurrent monomorphic VT with a left-bundle pattern. Electrophysiology shows His activation preceding each ventricular complex and entrainment through the conduction system. What is the likely mechanism?

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Correct answer: A — Bundle-branch re-entry

Bundle-branch re-entry is a macro-re-entrant ventricular tachycardia using the diseased His–Purkinje system, classically in dilated cardiomyopathy with conduction delay. Ablation of a bundle branch is often curative, while the underlying cardiomyopathy determines ICD need.

Reference: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines