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Arrhythmic Syncope After Aortic Valve Replacement

Pacing and Clinical Electrophysiology2025Vol. 48(6), pp. 598–602

Roberto Carlos Alvarez Coello Coello, Muhieddine Omar Chokr, Rodrigo Melo Kulchetscki, Hugo Cardoso de Souza Falcon, Victor Hugo dos Santos Sousa, Maurício Scanavacca

Abstract

We present the case of a young man who suffered from severe aortic valve insufficiency and subsequently underwent mechanical aortic prosthesis replacement. One month post-surgery, he presented with syncope and incessant ventricular tachycardia (VT), progressing to cardiogenic shock, which required emergency intra-aortic balloon pump (IABP) support. The VT proved refractory to standard clinical management and demonstrated responsiveness only after IABP support. An electrophysiological study was conducted; however, VT could not be induced during the procedure. Through electrophysiological maneuvers, we suspected bundle branch reentrant ventricular tachycardia (BBR-VT), and successful treatment was achieved via right bundle branch (RBB) ablation.

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