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Wide QRS Tachycardia in WPW: When Antidromic AVRT Imitates VT
Aleksandra Grbović1, Ružica Jurčević1, Sladjana Božović-Ogarević1
1Dedinje Cardiovascular Institute Belgrade Serbia.
Clinical Case Reports
|March 9, 2026
Summary
Antidromic Atrioventricular Re-entry Tachycardia (AVRT) can mimic ventricular tachycardia. Radiofrequency ablation successfully treated a patient with this condition, highlighting its effectiveness for wide QRS tachycardia.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Arrhythmias
Background:
- Atrioventricular Re-entry Tachycardia (AVRT) involves accessory pathways (AP) and can present with wide QRS complexes.
- Antidromic AVRT, resulting from anterograde conduction through an AP, may be misdiagnosed as ventricular tachycardia (VT).
Purpose of the Study:
- To present a case of recurrent wide QRS tachycardia due to antidromic AVRT.
- To discuss the differential diagnosis of wide QRS tachycardia, including antidromic AVRT.
- To highlight the efficacy of catheter ablation in treating this condition.
Main Methods:
- Electrophysiology study to identify the accessory pathway.
- Radiofrequency catheter ablation to eliminate pre-excitation.
- Implantation of an implantable cardioverter-defibrillator (ICD).
Main Results:
- A left posterolateral accessory pathway was identified.
- Radiofrequency ablation successfully eliminated pre-excitation.
- ICD implantation was performed without complications.
Conclusions:
- Antidromic AVRT should be considered in the differential diagnosis of wide QRS tachycardia.
- Catheter ablation is a safe and effective treatment for antidromic AVRT.
- Successful management of a patient with ischemic cardiomyopathy and antidromic AVRT.
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