Latent atriofascicular pathway participating in a wide complex tachycardia: differentiation from ventricular tachycardia.
Accessory pathways with anterograde decremental conduction properties usually are characterized by presence of antegrade preexcitation during atrial pacing. We report a 38-year-old man with frequent episodes of palpitation. No evidence of ventricular preexcitation was seen during sinus rhythm or atrial pacing. All electrophysiologic maneuvers were compatible with an antidromic tachycardia using atriofascicular pathway as the antegrade limb and the atrioventricular nodal pathway as retrograde limb. Radiofrequency ablation at recording site of accessory pathway potential resulted in cure of tachycardia with no recurrence during 3-month follow-up. This report indicated that atriofascicular pathway-mediated tachycardia should be considered in differential diagnosis of all cases of wide complex tachycardia with left bundle branch morphology and left axis.
Jorat
Mohammad V
MV
Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Haghjoo
Majid
M
Alizadeh
Abolfath
A
Fazelifar
Amir Farjam
AF
Nikoo
Mohammad H
MH
Emkanjoo
Zahra
Z
Sadr-Ameli
Mohammad A
MA
D000328:Adult; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D006325:Heart Atria / Q000002:abnormalities*; D006329:Heart Conduction System / Q000002:abnormalities*; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009434:Neural Pathways / Q000002:abnormalities*; D017180:Tachycardia, Ventricular / Q000175:diagnosis*