title: [Double tachyarrhythmia: left anterior fascicular ventricular tachycardia associated with atrial flutter and fibrillation. Report of a case].
abstract: A patient with episodes of palpitation in whom the electrocardiogram showed a right bundle branch (RBBB) configuration and right axis deviation underwent electrophysiologic study and radiofrequency ablation. Left ventricular endocardial mapping during ventricular tachycardia (VT) identified the earliest ventricular activation in the anterolateral wall of the left ventricle. The fused Purkinje potential was recorded at that site, and preceded the QRS complex by 47 mseg, with pace mapping showing an optimal match between the paced rhythm and the clinical VT. The stimulus to QRS time was equal to the Purkinje potential-QRS time. Several radiofrequency lesions were applied in this region, one of them resulted with termination of the tachycardia. Following delivery of this lesion the ventricular tachycardia couldn't be induced either at baseline or during isoproterenol infusion. During VT, atrial fibrillation and atrial flutter were observed, cardioversion was performed reverting to sinus rhythm.
authors.affiliation: Departamento de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
authors.forename: P
authors.initials: P
authors.lastname: Iturralde Torres
authors.forename: I J
authors.initials: IJ
authors.lastname: González Pavón
authors.forename: M E
authors.initials: ME
authors.lastname: Guevara Valdivia
authors.forename: L
authors.initials: L
authors.lastname: Colín Lizalde
authors.forename: C E
authors.initials: CE
authors.lastname: Roa
authors.forename: A
authors.initials: A
authors.lastname: Carrillo García
authors.forename: A
authors.initials: A
authors.lastname: de Micheli
authors.forename: J A
authors.initials: JA
authors.lastname: González Hermosillo
mesh_terms: D001282:Atrial Flutter / Q000150:complications* / Q000175:diagnosis; D002037:Bundle-Branch Block / Q000150:complications; D017115:Catheter Ablation; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011690:Purkinje Fibers / Q000502:physiology; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000175:diagnosis; D014693:Ventricular Fibrillation / Q000150:complications* / Q000175:diagnosis; D016277:Ventricular Function, Left