Why the study?
The mechanism underlying a very unusual wide QRS tachycardia in a young patient was unclear and required electrophysiologic characterization.
Case Report (n=1)
This case report describes an unusual wide QRS tachycardia in a pediatric patient caused by an atriofascicular fiber with AV nodal-like longitudinal dissociation.
May guide EP mapping in recurrent pediatric wide QRS tachycardia; leaves open generalizability of tricuspid annulus ablation.
INTRODUCTION: A 13 old girl presented with recurrent wide QRS tachycardia since she was 4. METHODS: An electrophysiologic study was performed. RESULTS: The electrophysiologic study showed that QRS complexes identical to those of the tachycardia could be elicited with premature atrial extrastimuli but with a shorter atrioventricular (AV) delay when the QRS was wide compared with narrow QRS complexes. The tachycardia was ablated at 9 o'clock on the tricuspid annulus demonstrating the presence of an atriofascicular fiber. CONCLUSION: We believe that this atypical behavior can be explained by AV nodal like longitudinal dissociation of a slowly conducting accessory pathway.
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Verbeet et al. (2022) conducted a case report in Recurrent wide QRS tachycardia (n=1). Electrophysiologic study and ablation was evaluated on Electrophysiologic characteristics and ablation success.
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