A very unusual wide QRS tachycardia: VT or SVT?
Thierry Verbeet1, Thomas Nguyen1, Jose Castro1
1Department of Cardiology, CHU Brugmann, Free University of Brussels, Brussels, Belgium.
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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