Bidirectional Ventricular Tachycardia Atypical: Case Report

Introduction: Bidirectional ventricular tachycardia (BVT) secondary is an entity characterized mainly by digital intoxication; if it`s not secondary a intoxication is considered of atypical presentation. The colaminergic ventricular tachycardia (CVT) is associated to this type of ventricular tachycardia.
Material and Methods: Female patient, 20 years old, who began his suffering 2 years ago, with record palpitations and recurrent syncope. Holter of 24 hours with extrasystolic load of 8% symptomatic with duplet, ventricular extrasystoles of 3 morphologies and incident of ventricular tachycardia of 4 heartbeats that is associated to sprout of type bidirectional. Stress test showed ventricular tachycardia not sustained of 15 heartbeats bidirectional in the third stage, sometimes alternates with nodal rhythm, with electrocardiography (ECG) structurally healthful.
In ECG and ablation reported a extrasystole of three morphologies, the first with morphology of left bundle branch block, the second with right bundle branch block with V1 type QS lower axis and third of right bundle branch block in lower axis. Considered successful ablation to ventricular tachycardia of one type morphology, the others failed. Was placed implantable cardioverter defibrillator (ICD) as a secondary prevention of sudden death.
Conclusion: The presence of atypical BVT was shown in absence of digital intoxication in heart structurally healthful secondary to CVT as a manifestation of effort. The colaminergic polymorphic ventricular tachycardia is a rare disease, heterogeneous clinical and genetically, sporadic or hereditary familiar, characterized by sudden appearance of polymorphic or BVT crisis unchained by adrenergic stress psychophysical and could bring to syncope or sudden death.