Exercise-Provoked Bidirectional Ventricular Tachycardia in a Young Woman

Exercise-induced ventricular tachycardia (VT) is rare in children and young adults without structural heart disease. Catecholaminergic polymorphic VT (CPVT) is among the possible causes and carries a poor prognosis. The QRS morphology of CPVT can be bidirectional, polymorphic or even ventricular fibrillation. We report a case of CPVT initially presenting as sudden collapse in an 18-year-old Taiwanese woman. Family history was negative for arrhythmias and sudden death. Laboratory analyses , transthoracic echocardiography, magnetic resonance imaging, electrophysiological study including procainamide and isoproterenol test were all negative. Bidirectional VT was induced by treadmill exercise test . She responded well to beta-blocker therapy. Some cases of CPVT are sporadic and some occur in patients with a family history. The treatment of choice for this disease is beta-blocker and implantation of an internal cardioverter defibrillato