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Updated: May 22, 2026

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
Published on: February 17, 2018
Wide Complex Tachycardia: An Enigmatic Sequence
Albert Roig1, Alfonso Tolentino2
1Department of Artificial Intelligence, EKGDX, Miami, Florida, USA.
Background:
Differentiating perpetuated aberrant conduction from ventricular tachycardia in atrial fibrillation (AF) is challenging and may lead to inappropriate therapies.
Case Summary:
A 64-year-old man with ischemic cardiomyopathy and AF presented with decompensated heart failure. Admission electrocardiogram showed a wide-complex tachycardia with runs of up to 10 consecutive aberrant QRS complexes mimicking nonsustained ventricular tachycardia (VT). Careful analysis revealed perpetuated Ashman-type aberrancy best explained by concealed transseptal conduction. Abrupt normalization despite a subsequent long-short sequence most likely reflected transient resolution of functional right bundle branch fatigue.
Discussion:
This case demonstrates an unusually long run of perpetuated Ashman-type aberrancy in AF, a rare diagnostic challenge that mimics nonsustained VT and carries risk of inappropriate treatment.
Take-Home Messages:
Long runs of wide QRS complexes in AF may reflect perpetuated aberrancy rather than VT. Accurate recognition of this phenomenon is essential to avoid unnecessary and potentially harmful therapies.
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