[Wide QRS complex tachycardia in a patient with ischemic cardiomyopathy and prior ventricular tachycardia ablation].
METHODS
This article reports the case of a 76-year-old patient with multiple implantable cardioverter defibrillator (ICD) interventions of the single chamber ICD. On admission the 12-lead electrocardiogram (ECG) documented a wide QRS complex tachycardia without clearly identifiable P waves. The patient had previously had two ventricular tachycardia (VT) ablations due to VT storms. The resting ECG revealed a sinus rhythm with a wide QRS complex. During the electrophysiological investigation typical atrial flutter could be detected and an ablation of the cavotricuspid isthmus was performed. During the follow-up period, the patient has been free from tachycardia.


CONCLUSIONS
The case described emphasizes that a differentiation between supraventricular tachycardia (SVT) and VT based on a stored ECG without an atrial channel can be challenging.
Department of Medicine-Cardiology, Charité Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland. bogdan-george.muntean@charite.de.
Bogdan G
BG
Muntean
Department of Medicine-Cardiology, Charité Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
Mattias
M
Roser
Department of Medicine-Cardiology, Charité Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
Saba
S
Suhail
Department of Medicine-Cardiology, Charité Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
Patrick
P
Nagel
Department of Medicine-Cardiology, Charité Berlin Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
Barbara
B
Bellmann
D009202:Cardiomyopathies / Q000150:complications* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000175:diagnosis*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000601:surgery*
Ablation; Atrial flutter; Electrical storm; Implantable cardioverter-defibrillator; Ventricular tachycardia