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Published on: February 22, 2018
A broad complex tachycardia with conflicting information from pacing manoeuvres
Ross J Hunter1, Malcolm Finlay, Richard J Schilling
1Cardiology Research Department, Barts and The London NHS Trust and QMUL, St Bartholomew's Hospital, First Floor Dominion House, 60 Bartholomew Close, West Smithfield, London EC1A 7BE, UK. ross.hunter@bartsandthelondon.nhs.uk
Abstract:
A patient with a biventricular implantable cardioverter defibrillator for heart failure had a recurrent broad complex tachycardia and underwent electrophysiologic testing. The tachycardia was induced only with ventricular pacing. There was a 1:1 atrioventricular relationship with simultaneous atrial and ventricular activation. However, atrial pacing during tachycardia suggested atrial dissociation from the circuit. The findings, potential mechanisms, and treatment are discussed.
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