Wide QRS tachycardia: What is the mechanism?

摘要

A 47-year-old woman with regular wide QRS tachycardia without any structural heart disease was referred to our center for catheter ablation. The tachycardia was terminated by direct current cardioversion. A 12-lead electrocardiogram showed intraventricular conduction delay in sinus rhythm (Fig. 1A). The morphology of QRS during the tachycardia (Fig. IB) was similar to that in sinus rhythm. Baseline electrophysiological test demonstrated a long HV interval (102 milliseconds) (Fig. 2A) and dual atrioventricular nodal physiology with antegrade pathway. The inducibility of the tachycardia was very low by programmed stimulation