Resolution of the functional retrograde right bundle branch block during antidromic atrioventricular reciprocating tachycardia

Figures

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  Figure 1. Twelve-lead electrocardiograms obtained during (A) clinical supraventricular tachycardia (SVT1) and (B) sinus rhythm. SVT1 was shown to be a wide QRS complex tachycardia (200 beats/min) with left bundle branch block morphology (panel A). Ventricular preexcitation was seen during sinus rhythm, suggestive of the presence of a right lateral accessory pathway (panel B).

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  Figure 2. Intracardiac electrograms obtained during clinical supraventricular tachycardia (SVT1), antidromic atrioventricular reciprocating tachycardia that used a right lateral accessory pathway with shortening cycle lengths. The cycle length of the tachycardia decreased gradually along with the shortening of the ventricular-His interval and a slight prolongation of the His-atrial interval, suggesting resolution of the functional retrograde right bundle branch block. CS = coronary sinus; HBE = His bundle electrogram; HRA = high right atrium; RVA = right ventricular apex.

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  Figure 3. Intracardiac electrograms of the 3 additional supraventricular tachycardias (SVTs). Atrioventricular reciprocating tachycardia (AVRT) that used a right lateral accessory pathway as the anterograde limb and left posterolateral accessory pathway (LPLAP) as the retrograde limb at a tachycardia cycle length (CL) of 326 ms (SVT2), orthodromic AVRT that used an LPLAP at a tachycardia CL of 258 ms (SVT3), and common atrioventricular nodal reentrant tachycardia at a CL of 440 ms (SVT4) were induced. AP = accessory pathway; AVNRT = atrioventricular nodal reentrant tachycardia; CS = coronary sinus; HBE = His bundle electrogram; HRA = high right atrium; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle; RVA = right ventricular apex.