On the mechanism of paroxysmal tachycardia with rhythmic alternation in the direction of the ventricular complexes

Abstract

1. 1. A case of paroxysmal tachycardia with rhythmic alternation in the direction of the ventricular complexes in the electrocardiogram is reported together with a review of the literature. 2. 2. There have been thirty-two cases of bidirectional alternating ventricular tachycardia recorded in the literature, most of these associated with severe cardiac damage and digitalis administration. 3. 3. We have presented clinical and electrocardiographic evidence which suggests that in our patient the mechanism was due to the action of two separate foci, one in the A-V nodal tissues above the bifurcation of the bundle of His the other in the ventricular muscle.