Verbeet T, Nguyen T, Castro J. A very unusual wide QRS tachycardia: VT or SVT?
J Cardiovasc Electrophysiol 2023;
34:231-234. [PMID:
36571151 DOI:
10.1111/jce.15793]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/20/2022] [Accepted: 12/20/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION
A 13 old girl presented with recurrent wide QRS tachycardia since she was 4.
METHODS
An electrophysiologic study was performed.
RESULTS
The electrophysiologic study showed that QRS complexes identical to those of the tachycardia could be elicited with premature atrial extrastimuli but with a shorter atrioventricular (AV) delay when the QRS was wide compared with narrow QRS complexes. The tachycardia was ablated at 9 o'clock on the tricuspid annulus demonstrating the presence of an atriofascicular fiber.
CONCLUSION
We believe that this atypical behavior can be explained by AV nodal like longitudinal dissociation of a slowly conducting accessory pathway.
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