What is the clinical evidence from this study?

Study design: Case Report. Population: Ventricular tachycardia mimicking supraventricular tachyarrhythmia (n=1). Intervention: Radiofrequency ablation. Primary outcome: Recurrence of tachycardia.

What does this research mean for the field?

Radiofrequency ablation successfully treated a reentry circuit ventricular tachycardia on an ischemic scar that presented atypically with RBBB and LAFB morphology, with no recurrence at 6 months. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Identify the precise electrophysiological mechanism and provide definitive management for a relatively narrow-complex tachyarrhythmia initially misdiagnosed as supraventricular in origin.

September 15, 2026European Heart Journal Supplements

An Atipical Supraventricular Tachyarrhythmia

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Key result

RFA eliminates ischemic scar reentry VT presenting with RBBB and LAFB morphology without 6-month recurrence.

Population

1 76-year-old patient presenting with dyspnea and tachyarrhythmia with a history of paroxysmal atrial…

Design

Case_report

Follow-up

6 months

Authors

GVG VitulanoUniversity of Salerno FFF Di FraiaUniversity of Salerno NKN KolaUniversity of Salerno

Discussion

Member takes

Implication

May support ablation feasibility in scar-related VT with RBBB/LAFB morphology; hypothesis-generating and requires prospective validation.

Key Points

Identify the precise electrophysiological mechanism and provide definitive management for a relatively narrow-complex tachyarrhythmia initially misdiagnosed as supraventricular in origin.
Evaluated a 76-year-old patient presenting with tachycardia (150 bpm, QRS width 115 ms) who underwent coronary angiography and stenting of the mid-LAD due to elevated troponin.
Conducted an invasive electrophysiological study with programmed electrical stimulation, left ventricular voltage and activation mapping, and radiofrequency ablation after arrhythmia recurred despite antiarrhythmic therapies.
Electrophysiological mapping confirmed a reentry circuit ventricular tachycardia with retrograde atrial conduction originating near the posterior fascicle at an inferoseptal ischemic scar.
Application of 35 W radiofrequency energy at the site of presystolic potentials (-45 ms activation) achieved complete non-inducibility of the tachycardia, with zero recurrence observed at 6-month follow-up.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 76-year-old patient presenting with dyspnea and a tachyarrhythmia initially misdiagnosed as supraventricular, followed for 6 months after ablation.

Intervention

Electrophysiology study and radiofrequency ablation (35 W) of an ischemic scar in the inferior septal area, following PTCA and stenting of a critical mid-LAD stenosis.

Outcome

Recurrence of tachycardia

A relatively narrow QRS tachycardia with RBBB and LAFB morphology should not rule out ventricular tachycardia, particularly scar-related reentry circuits mimicking fascicular VT.

Cite This Study

Vitulano et al. (2026) conducted a case report in Ventricular tachycardia mimicking supraventricular tachyarrhythmia (n=1). Radiofrequency ablation was evaluated on Recurrence of tachycardia. Radiofrequency ablation successfully treated a reentry circuit ventricular tachycardia on an ischemic scar that presented with RBBB and LAFB morphology, with no recurrence at 6 months.

synapsesocial.com/papers/6aa9016aeed42882c1fc180a https://doi.org/10.1093/eurheartjsupp/suag058.119

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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An Atipical Supraventricular Tachyarrhythmia

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

An Atipical Supraventricular Tachyarrhythmia

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

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