Mapping and ablation of a narrow QRS tachycardia in a patient with ischemic cardiomyopathy

摘要

A 61-year-old woman with Leriche's syndrome, ischemic cardiomyopathy (left ventricular ejection fraction 24% after inferior myocardial infarction), and a single-chamber im-plantable cardioverter-defibrillator (ICD) presented to the hospital with palpitations. The electrocardiogram (ECG) (Fig. 1, left panel) revealed a relatively narrow QRS complex tachycardia (NCT, QRS width 104 ms), slightly irregular at 154 beats per minute (bpm) without visible P waves. Intermittently, more narrow QRS complexes were observed after shorter intervals (evident in beat 3).