AF-Triggered Bundle Branch Re-Entrant Ventricular Tachycardia Prevented by Atrial Fibrillation Ablation
- 1Department of Cardiology, Nara Prefecture General Medical Center, Nara, Japan
- 2Department of Cardiovascular Medicine, Nara Medical University, Nara, Japan
Abstract
Background: Bundle branch re-entrant ventricular tachycardia (BBR-VT) is a macroreentrant tachycardia involving the right and left bundle branches,1 with the right bundle branch typically targeted for ablation.
Case Summary: A 68-year-old man with prior myocardial infarction presented with recurrent ventricular tachycardia (VT). Electrophysiological study suggested BBR-VT. VT was inducible only by atrial pacing and occurred clinically exclusively during atrial fibrillation (AF). Therefore, AF ablation alone was performed, resulting in complete suppression of VT.
Discussion: Previous reports have described BBR-VT induced by atrial pacing2 or AF.3 When BBR-VT is triggered exclusively by AF, AF ablation may be an effective therapeutic strategy.
Take-Home Messages: In patients with BBR-VT that is triggered exclusively by atrial fibrillation or atrial pacing, elimination of the triggering atrial arrhythmia may suppress VT without the need for bundle branch ablation. Even when AF ablation is effective, implantable cardioverter-defibrillator implantation and careful long-term follow-up remain essential because recurrence of atrial tachyarrhythmias may precipitate VT recurrence.
Related
- Global Advances in Ventricular Tachycardia Ablation
- Transatrial air-assisted epicardial ventricular tachycardia ablation for hypertrophic cardiomyopathy and management of postprocedural right atrial thrombus.
- Persistence of atrioventricular nodal re-entrant tachycardia during ventricular fibrillation.
- Thirty years of percutaneous epicardial access: reflections on the evolution of ventricular tachycardia substrate mapping and ablation
- Successful Catheter Ablation of Basal Crux Ventricular Tachycardia with Right Bundle Branch Block Morphology in a Patient with Dilated Cardiomyopathy
BibTeX
@article{sakai2026aftriggered,
title = {{AF-Triggered Bundle Branch Re-Entrant Ventricular Tachycardia Prevented by Atrial Fibrillation Ablation}},
author = {Satoshi Sakai and Taku Nishida and Akihiro Takitsume and Tsunenari Soeda and Hiroyuki Kawata and Shungo Hikoso},
journal = {JACC Case Reports},
year = {2026},
month = aug,
doi = {10.1016/j.jaccas.2026.109802},
url = {https://doi.org/10.1016/j.jaccas.2026.109802},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - AF-Triggered Bundle Branch Re-Entrant Ventricular Tachycardia Prevented by Atrial Fibrillation Ablation
AU - Satoshi Sakai
AU - Taku Nishida
AU - Akihiro Takitsume
AU - Tsunenari Soeda
AU - Hiroyuki Kawata
AU - Shungo Hikoso
PY - 2026
DA - 2026/08/12
JO - JACC Case Reports
DO - 10.1016/j.jaccas.2026.109802
UR - https://doi.org/10.1016/j.jaccas.2026.109802
AB - Background: Bundle branch re-entrant ventricular tachycardia (BBR-VT) is a macroreentrant tachycardia involving the right and left bundle branches,1 with the right bundle branch typically targeted for ablation. Case Summary: A 68-year-old man with prior myocardial infarction presented with recurrent ventricular tachycardia (VT). Electrophysiological study suggested BBR-VT. VT was inducible only by atrial pacing and occurred clinically exclusively during atrial fibrillation (AF). Therefore, AF ablation alone was performed, resulting in complete suppression of VT. Discussion: Previous reports have described BBR-VT induced by atrial pacing2 or AF.3 When BBR-VT is triggered exclusively by AF, AF ablation may be an effective therapeutic strategy. Take-Home Messages: In patients with BBR-VT that is triggered exclusively by atrial fibrillation or atrial pacing, elimination of the triggering atrial arrhythmia may suppress VT without the need for bundle branch ablation. Even when AF ablation is effective, implantable cardioverter-defibrillator implantation and careful long-term follow-up remain essential because recurrence of atrial tachyarrhythmias may precipitate VT recurrence.
SN - 2666-0849
ER -