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[Bundle-branch reentry ventricular tachycardia induced by sinus beat].

A spontaneous episode of bundle branch reentry ventricular tachycardia was recorded in a 50 year old man few weeks after operation for a severe aortic valve regurgitation. After surgery, the patient developed recurrent syncope and showed a bradycardia-dependent left bundle branch block and a HV interval of 70 ms. A bundle branch reentry ventricular tachycardia with left bundle branch block morphology, easily induced during premature ventricular stimulation, occurred spontaneously after the longest sinus cycle of a sequence conducted to the ventricles with a left bundle branch block morphology of the QRS complexes. During left bundle branch block an incomplete and concealed anterograde conduction along the left bundle branch was supposed to be present and its disappearance was considered the trigger mechanism of the spontaneous ventricular tachycardia. The negative results obtained with the signal-averaged ECG in our case support the concept that intramyocardial delay is not essential for this type of ventricular tachycardia.