Arrhythmic Syncope After Aortic Valve Replacement

We present the case of a young man who suffered from severe aortic valve insufficiency and subsequently underwent mechanical aortic prosthesis replacement. One month post-surgery, he presented with syncope and incessant ventricular tachycardia (VT), progressing to cardiogenic shock, which required emergency intra-aortic balloon pump (IABP) support. The VT proved refractory to standard clinical management and demonstrated responsiveness only after IABP support. An electrophysiological study was conducted; however, VT could not be induced during the procedure. Through electrophysiological maneuvers, we suspected bundle branch reentrant ventricular tachycardia (BBR-VT), and successful treatment was achieved via right bundle branch (RBB) ablation.