@article {Alrifai288, author = {Abdulah Alrifai and Mohamad Kabach and Jonathan Nieves and Robert Chait}, title = {Left Ventricular Aneurysm Presenting as Bidirectional Ventricular Tachycardia}, volume = {18}, number = {3}, pages = {288--290}, year = {2018}, doi = {10.31486/toj.18.0023}, publisher = {Ochsner Journal}, abstract = {Background: Bidirectional ventricular tachycardia is a rare form of ventricular arrhythmia, characterized by a changing of the mean QRS axis of 180 degrees. Digitalis toxicity is the most common cause of bidirectional ventricular tachycardia; other causes include myocarditis, aconite toxicity, metastatic cardiac tumor, myocardial infarction, and cardiac channelopathies.Case Report: A 73-year-old male with hypertension and a pacemaker implanted for sick sinus syndrome presented with a complaint of substernal chest pressure for several days. He also stated he had had an episode of near syncope. The patient{\textquoteright}s physical examination was unremarkable; however, electrocardiogram demonstrated sustained bidirectional ventricular tachycardia. Echocardiogram showed severe anterior wall hypokinesis and an estimated ejection fraction of 35\%, as well as an apical ventricular aneurysm. Electrophysiology study showed that the apical ventricular aneurysm was the site of the bidirectional arrhythmia. The patient was successfully treated with ventricular tachycardia ablation.Conclusion: This case is a unique example of a patient with bidirectional ventricular tachycardia originating from an apical left ventricular aneurysm that was treated successfully by ablation.}, issn = {1524-5012}, URL = {https://www.ochsnerjournal.org/content/18/3/288}, eprint = {https://www.ochsnerjournal.org/content/18/3/288.full.pdf}, journal = {Ochsner Journal} }