Left posterior fascicular tachycardia: a diagnostic and therapeutic challenge.
A wide QRS complex tachycardia with right bundle-branch block morphology and left axis deviation observed in a young patient without structural heart disease may pose a diagnostic and therapeutic challenge. The surface ECG may provide several diagnostic clues to make a correct diagnosis of left posterior fascicular tachycardia and may help to differentiate it from both a supraventricular tachycardia with aberrant conduction and a typical ventricular tachycardia related to coronary artery disease. Although this tachycardia is sensitive to verapamil, this medication may probably cause transient infertility in males. The presence of a Purkinje potential preceding the QRS complex during tachycardia and optimal pace mapping may guide radio-frequency ablation resulting in a definite cure.
Peeters
H
H
Department of Cardiology, AZ Damiaan Hospital, Oostende, Belgium.
Vandenbulcke
F
F
Slabbinck
E
E
Bouckhout
P
P
Duhein
B
B
Stroobandt
R
R
D000328:Adult; D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis* / Q000601:surgery