A case with occurrence of antidromic tachycardia after ablation of idiopathic left fascicular tachycardia: mechanism of left upper septal ventricular tachycardia.
A 36-year-old male presented with verapamil-sensitive narrow QRS tachycardia. The patient underwent the catheter ablation of common idiopathic left fascicular ventricular tachycardia (ILVT) 2 years ago. During narrow QRS tachycardia, the diastolic and presystolic potentials (P1 and P2) were recorded at the left septum. Activation sequences of P1 and P2 were opposite from those in common ILVT. Entrainment of P1 at the upper septum exhibited concealed fusion and S-QRS equal to P1-QRS. Radiofrequency current to P1 suppressed VT. Idiopathic left upper septal VT might be the antidromic macroreentry of the common form of ILVT.
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. su9uru@me.com
Suguru
S
Nishiuchi
Akihiko
A
Nogami
Shigeto
S
Naito
D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects; D004562:Electrocardiography; D006801:Humans; D008297:Male; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000601:surgery*
catheter ablation; entrainment; idiopathic left ventricular tachycardia; ventricular tachycardia