Key result
Radiofrequency ablation near the left and right coronary cusp commissure successfully terminated the wide complex QRS tachycardias, which originated from the L-RCC with three breakout sites.
Case Report (n=1)
This case demonstrates the importance of recognizing preferential conduction routes from the left and right coronary cusp commissure when mapping and ablating wide complex QRS tachycardias with multiple morphologies.
Emphasizes broad differential in wide complex tachycardia; leaves open optimal diagnostic algorithms for rare pre-excited variants.
The differential diagnosis for a wide complex tachycardia includes all causes of supraventricular tachycardia (SVT) with bundle branch block or all causes of SVT with antegrade pre-excitation by bystander involvement of any accessory pathways, myocardial or bundle brunch ventricular tachycardia, and antidromic (atriofascicular or nodofascicular/nodoventricular) and other pre-excited reciprocating tachycardias. We present a case of wide complex QRS tachycardia with a left bundle branch block QRS morphology.
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Deveci et al. (2021) conducted a case report in Wide QRS Tachycardia (n=1). Electrophysiological study and radiofrequency ablation was evaluated on Termination of tachycardia. Radiofrequency ablation near the left and right coronary cusp commissure successfully terminated the wide complex QRS tachycardias, which originated from the L-RCC with three breakout sites.
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