Bidirectional Ventricular Tachycardia Culminating in Cardiac Arrest: A Diagnostic and Management Conundrum.
SV, L., AB, A., PJ, N., & YY, L. (2026). Bidirectional Ventricular Tachycardia Culminating in Cardiac Arrest: A Diagnostic and Management Conundrum.. The Journal of the Association of Physicians of India. https://doi.org/10.59556/japi.74.1356
SV L, AB A, PJ N, YY L. Bidirectional Ventricular Tachycardia Culminating in Cardiac Arrest: A Diagnostic and Management Conundrum.. The Journal of the Association of Physicians of India. 2026; doi: 10.59556/japi.74.1356
SV L, AB A, PJ N, et al. Bidirectional Ventricular Tachycardia Culminating in Cardiac Arrest: A Diagnostic and Management Conundrum.[J]. The Journal of the Association of Physicians of India. 2026. DOI: 10.59556/japi.74.1356.
@article{sv2026,
author = {Limaye SV and Anand AB and Nathani PJ and Lokhandwala YY},
title = {Bidirectional Ventricular Tachycardia Culminating in Cardiac Arrest: A Diagnostic and Management Conundrum.},
journal = {The Journal of the Association of Physicians of India},
year = {2026},
doi = {10.59556/japi.74.1356},
note = {PMID: 42543975},
}
TY - JOUR AU - Limaye SV AU - Anand AB AU - Nathani PJ AU - Lokhandwala YY TI - Bidirectional Ventricular Tachycardia Culminating in Cardiac Arrest: A Diagnostic and Management Conundrum. T2 - The Journal of the Association of Physicians of India PY - 2026 DO - 10.59556/japi.74.1356 AN - PMID:42543975 ER -
Bidirectional ventricular tachycardia (BDVT) is a rare arrhythmia marked by beat-to-beat QRS axis alteration. We report a 36-year-old female with recurrent palpitations who presented with BDVT degenerating into polymorphic ventricular tachycardia and ventricular fibrillation. An extensive evaluation, including cardiac magnetic resonance imaging (MRI), stress and adrenaline provocation testing, and a comprehensive genetic arrhythmia panel, revealed no definitive etiology. Given the concern for proarrhythmic implantable cardioverter-defibrillator (ICD) shocks in a potential channelopathy and after shared decision-making, the patient was managed with high-dose beta blocker therapy. This case underscores the diagnostic and management challenges of BDVT in a structurally normal heart, particularly when balancing guideline recommendations against individualized patient factors.