A broad complex tachycardia with conflicting information from pacing manoeuvres.
A patient with a biventricular implantable cardioverter defibrillator for heart failure had a recurrent broad complex tachycardia and underwent electrophysiologic testing. The tachycardia was induced only with ventricular pacing. There was a 1:1 atrioventricular relationship with simultaneous atrial and ventricular activation. However, atrial pacing during tachycardia suggested atrial dissociation from the circuit. The findings, potential mechanisms, and treatment are discussed.
Hunter
Ross J
RJ
Cardiology Research Department, Barts and The London NHS Trust and QMUL, St Bartholomew's Hospital, First Floor Dominion House, 60 Bartholomew Close, West Smithfield, London EC1A 7BE, UK. ross.hunter@bartsandthelondon.nhs.uk
Finlay
Malcolm
M
Schilling
Richard J
RJ
Sporton
Simon
S
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D006801:Humans; D008297:Male; D014693:Ventricular Fibrillation / Q000175:diagnosis*