Arrhythmias & electrophysiology
Mechanisms of ventricular tachycardias with a 1:1 His-V relation in patients with heart disease
Authors' conclusion
Retrograde HisRB activation is common in all forms of VT. HisRB timing and new features based on consideration of orthodromic HisRB activation during RV pacing can help distinguish BBR-VT, SRR-VT, and FPVT.
Study context
- Population
- Patients with heart disease and induced ventricular tachycardia (VTs) with a HisRB potential recorded while pacing from the distal right ventricular (RV)158 VTs analysed
- Participants
- 147 patients
- Exposure
- BBR-VT vs FPVT vs SRR-VT
- BBR-VTn = 18
- FPVTn = 8
- SRR-VTn = 60
- Outcome
- Frequency of 1:1 V-His relation and differentiating characteristics of these VTs
Main finding
As reported in the abstract
- 1:1 V to HisRB observed
- 86 VTs (54%)
- HisRB-QRSVT >135 ms, within the QRS, in scar-related reentrant VTs (SRR-VTs)
- 87%
- HisRB-QRSVT 30-135 ms in all bundle branch reentrant VTs (BBR-VTs)
- P < .001
- HisRB remained 1:1 with RV pacing in BBR-VTs
- 100%
- HisRB remained 1:1 with RV pacing in SRR-VTs
- 23 (69.7%) of 33
Observational data: associations, not effects.
Original publication
Mechanisms of ventricular tachycardias with a 1:1 His-V relation in patients with heart disease. Heart Rhythm. Published 4 March 2025. doi:10.
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