Bidirectional tachycardia

An uncommon form of tachycardia characterized by beat-to-beat alternation of the morphology and the axis of the QRS complexes seen in some of the ELECTROCARDIOGRAM leads. The usual ventricular rate ranges from 140 to 180 bpm and can be regular or irregular. It is usually associated with DIGITALIS toxicity, but may occur in cases of HYPERKALEMIC PERIODIC PARALYSIS; HYPOKALEMIC PERIODIC PARALYSIS; BRUGADA SYNDROME; and severe structural heart disease. (Anesth Analg. 2002 Aug;95(2):310-5)

Also Known As:

Bidirectional ventricular tachycardia

Networked: 66 relevant articles (4 outcomes, 0 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Andersen Syndrome
2.	Tachycardia (Tachyarrhythmias)
3.	Cardiomyopathies (Cardiomyopathy)
4.	Ventricular Tachycardia
5.	Cardiac Arrhythmias (Arrythmia)

Experts

1.	Sumitomo, Naokata: 3 articles (01/2013 - 03/2008)
2.	Napolitano, Carlo: 3 articles (02/2009 - 07/2002)
3.	Priori, Silvia G: 3 articles (02/2009 - 07/2002)
4.	Hiraoka, Masayasu: 3 articles (03/2008 - 03/2005)
5.	Bloise, Raffaella: 2 articles (02/2009 - 07/2002)
6.	Aizawa, Yoshifusa: 2 articles (05/2006 - 03/2005)
7.	Aizawa, Yoshiyasu: 2 articles (05/2006 - 03/2005)
8.	Chinushi, Masaomi: 2 articles (05/2006 - 03/2005)
9.	Komura, Satoru: 2 articles (05/2006 - 03/2005)
10.	Colombi, Barbara: 2 articles (05/2005 - 07/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Bidirectional tachycardia:

1.	Flecainide (Tambocor)FDA LinkGeneric 01/01/2023 - "Bidirectional Ventricular Tachycardia and Prominent U Waves: Look at Fingers and Muscles and Use Flecainide." 09/01/2020 - "The case also demonstrates the efficacy of flecainide in managing bidirectional ventricular tachycardia in the setting of Andersen Tawil syndrome." 12/01/2018 - "Can flecainide totally eliminate bidirectional ventricular tachycardia in pediatric patients with Andersen-Tawil syndrome?" 06/01/2022 - "Efficacy of flecainide in bidirectional ventricular tachycardia and tachycardia-induced cardiomyopathy with Andersen-Tawil syndrome." 06/01/2022 - "We report the successful use of flecainide in bidirectional ventricular tachycardia and tachycardia-induced cardiomyopathy in a case of Andersen-Tawil syndrome associated with a novel mutation."
2.	Lidocaine (Xylocaine)FDA LinkGeneric 07/01/1982 - "It is concluded that lignocaine can be useful in the treatment of digitalis-induced bidirectional tachycardia and atrial tachycardia with block. " 07/01/1982 - "This report, in contrast, deals with bidirectional tachycardia and the effects of lignocaine on 10 patients with this arrhythmia. " 07/01/1982 - "Effects of lignocaine on bidirectional tachycardia and on digitalis-induced atrial tachycardia with block." 07/01/1982 - "In one patient, a single bolus of lignocaine was followed (five minutes later) by ventricular fibrillation, but the other nine patients received two boluses of 75 mg followed by a drip infusion of 3 mg/min. The drug terminated the episodes of atrial tachycardia with block and bidirectional tachycardia in all patients thus treated. " 10/01/1992 - "[A case of aconitine poisoning accompanied by bidirectional ventricular tachycardia treated with lidocaine]."
3.	Digoxin (Digitek)FDA LinkGeneric 07/01/2014 - "Bidirectional ventricular tachycardia associated with digoxin toxicity and with normal digoxin levels." 01/01/2014 - "Bidirectional tachycardia is pathognomonic of digoxin intoxication, but it is rarely observed. " 07/01/2005 - "Bidirectional ventricular tachycardia resulting from digoxin toxicity." 02/20/1997 - "Digoxin-induced bidirectional ventricular tachycardia." 01/01/1995 - "Bidirectional tachycardia associated with digoxin toxicity."
4.	Ryanodine Receptor Calcium Release Channel (Ryanodine Receptor)IBA 04/01/2020 - "It has become clear that CPVT encompasses more than just uniformly expressed ryanodine receptor mutations leading to bidirectional ventricular tachycardia, rather it is a disease caused by different genetic mutations, overlapping with other entities and possibly affecting not only the heart. " 01/01/2013 - "In the RYR2 mutation-positive group, the frequency of bidirectional ventricular tachycardia and the use of β-blockers were significantly higher than in the mutation-negative group. " 02/01/2009 - "Among 175 patients screened on RyR2 gene, those with documented bidirectional ventricular tachycardia had the highest incidence (62%) of mutations and the lowest cost (US $5263) per positive genotyping. " 04/04/2006 - "A novel mutation (Arg169Gln) of the cardiac ryanodine receptor gene causing exercise-induced bidirectional ventricular tachycardia." 05/27/2005 - "Bidirectional ventricular tachycardia and fibrillation elicited in a knock-in mouse model carrier of a mutation in the cardiac ryanodine receptor."
5.	Adrenergic Agents (Adrenergic Drugs)IBA 01/01/2020 - "Genetic Loss of IK1 Causes Adrenergic-Induced Phase 3 Early Afterdepolariz ations and Polymorphic and Bidirectional Ventricular Tachycardia." 05/01/2012 - "The diagnosis is based on the demonstration of polymorphic or bidirectional ventricular tachycardia associated with adrenergic stress. " 12/01/2017 - "The diagnosis of CPVT is established in individuals with polymorphic ventricular premature beats, PVT or bidirectional ventricular tachycardia documented during exercise or adrenergic stress, who have a structurally normal heart and normal resting ECG. " 12/01/2009 - "Patients present with exertional syncope and the trademark dysrhythmia is polymorphic and/or bidirectional ventricular tachycardia during exercise or adrenergic stimulation. " 08/01/2016 - "Catecholaminergic polymorphic ventricular tachycardia (CPVT), an inherited arrhythmia often leading to sudden cardiac death in children and young adults, is characterized by polymorphic/bidirectional ventricular tachycardia induced by adrenergic stimulation associated with emotionally stress or physical exercise. "
6.	Isoproterenol (Isoprenaline)FDA LinkGeneric 10/01/2023 - "Bidirectional ventricular tachycardia (VT) induced by isoproterenol in this clinical scenario is strongly suggestive of CPVT. " 08/01/2009 - "Exercise or isoproterenol infusion may cause increased ventricular ectopy or bidirectional ventricular tachycardia. " 05/01/2006 - "Seven patients from 6 families with CPVT in which bidirectional tachycardia and polymorphic VT were induced by exercise or isoproterenol infusion visited our hospitals. " 04/06/1969 - "[Unusual occurrence of bidirectional tachycardia caused by Isuprel infusion]." 03/18/2005 - "Exercise on treadmill induced premature ventricular contraction in bigeminy and bidirectional ventricular tachycardia was induced during isoproterenol infusion. "
7.	Epinephrine (Adrenaline)FDA LinkGeneric 01/01/2022 - "When mice were challenged with caffeine-epinephrine, CD38KO mice had a lower incidence of bidirectional ventricular tachycardia when compared to WT ones. " 01/01/2014 - "Doxapram hydrochloride aggravates adrenaline-induced arrhythmias accompanied by bidirectional ventricular tachycardia." 01/01/2014 - "Doxapram hydrochloride itself did not induce arrhythmia but did induce bidirectional ventricular tachycardia after addition of adrenaline. " 01/01/2020 - "Following epinephrine and caffeine, only the R67Q+/- mice had bidirectional ventricular tachycardia, ventricular tachycardia, frequent ventricular ectopy, and/or bigeminy and optical mapping demonstrated high prevalence of spontaneous and sustained ventricular arrhythmia. " 01/01/2019 - "During recovery, on extracorporeal membrane oxygenation, epinephrine challenge in two children induced polymorphic ventricular tachycardia, bidirectional ventricular tachycardia, and ventricular fibrillation, which was cardioverted with flecainide in the 4-year-old. "
8.	Caffeine (No Doz)FDA LinkGeneric 11/01/2019 - "Bidirectional ventricular tachycardia induced by caffeine poisoning." 01/01/2022 - "When mice were challenged with caffeine-epinephrine, CD38KO mice had a lower incidence of bidirectional ventricular tachycardia when compared to WT ones. " 12/01/2020 - "Caffeine and dobutamine challenge induces bidirectional ventricular tachycardia in normal rats." 01/01/2020 - "Following epinephrine and caffeine, only the R67Q+/- mice had bidirectional ventricular tachycardia, ventricular tachycardia, frequent ventricular ectopy, and/or bigeminy and optical mapping demonstrated high prevalence of spontaneous and sustained ventricular arrhythmia. "
9.	PotassiumIBA 01/01/1988 - "Association of periodic paralysis and bidirectional tachycardia in this case and four previously reported cases suggests a strong relationship between this arrhythmia and potassium." 02/01/1954 - "Bidirectional ventricular tachycardia due to digitalis poisoning; response to potassium therapy and evaluation of arrhythmia mechanism."
10.	CatecholaminesIBA 02/23/2023 - "Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a rare electrical genetic disease characterized by ventricular polymorphic tachycardia and/or bidirectional ventricular tachycardia induced by the release of catecholamines caused by intense physical or emotional stress in structurally normal hearts. " 09/01/2002 - "A case of exercise-induced catecholamine-sensitive bidirectional ventricular tachycardia with alternating right and left bundle branch block patterns is reported in a young boy in the absence of structural heart disease, the conditions causing bidirectional ventricular tachycardia, and family history of such an event or sudden cardiac death. "

Therapies and Procedures

1.	Radiofrequency Ablation 12/01/2002 - "This report describes an unusual case of bidirectional tachycardia eliminated with radiofrequency ablation. " 12/01/2002 - "Bidirectional tachycardia eliminated with radiofrequency ablation." 09/01/2001 - "Bidirectional ventricular tachycardia after radiofrequency ablation of idiopathic left ventricular tachycardia."
2.	Therapeutics 05/15/1976 - "After intravenous injection of K-strophantoside temporarily a bidirectional tachycardia developed which enforced a discontinuation of the K-strophantoside therapy. " 09/01/2012 - "Although she received an implantation of implantable cardioverter defibrillator and beta-blocker therapy, the frequency of premature ventricular contraction and bidirectional ventricular tachycardia did not decrease. " 10/01/1989 - "We report a case of bidirectional tachycardia (BT) found on Holter recording (H-ECG), likely due to antiarrhythmic therapy with lorajmine. " 10/01/1989 - "[Bidirectional tachycardia during therapy with lorajmine]." 02/01/1954 - "Bidirectional ventricular tachycardia due to digitalis poisoning; response to potassium therapy and evaluation of arrhythmia mechanism."
3.	Implantable Defibrillators (Implantable Cardioverter-Defibrillator) 09/01/2013 - "Exercise-induced nonsustained bidirectional ventricular tachycardia was documented in 4 patients, 2 received implantable cardioverter-defibrillators (ICD) for primary prevention and 2 for secondary prevention. " 09/01/2012 - "Although she received an implantation of implantable cardioverter defibrillator and beta-blocker therapy, the frequency of premature ventricular contraction and bidirectional ventricular tachycardia did not decrease. "
4.	Intravenous Administration 01/01/2014 - "Bidirectional tachycardia after an acute intravenous administration of digitalis for a suicidal gesture."
5.	Secondary Prevention 09/01/2013 - "Exercise-induced nonsustained bidirectional ventricular tachycardia was documented in 4 patients, 2 received implantable cardioverter-defibrillators (ICD) for primary prevention and 2 for secondary prevention. "