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Approach to the Diagnosis and Management of Complex Fascicular Ventricular Tachycardias.
Circ Arrhythm Electrophysiol
December 2024
Division of Cardiology, University of California San Francisco (H.H.H., A.C.L., M.M.S.).
Complex ventricular tachycardias involving the fascicular system (fascicular ventricular tachycardias [FVTs]) can be challenging. In this review, we describe our approach to the diagnosis and ablation of these arrhythmias with 10 illustrative cases that involve (1) differentiation from supraventricular tachycardia; (2) assessment for atypical bundle branch reentry and other interfascicular FVTs; (3) examination of P1/P2 activation sequences in sinus rhythm, pacing, and tachycardia; and (4) entrainment techniques to establish the tachycardia mechanism and aid circuit localization. To summarize, 5 cases had prior ablation with 2 previously misdiagnosed as supraventricular tachycardia.
View Article and Find Full Text PDFThe pacing maneuvers for supraventricular tachycardia with cycle length alternans are sometimes difficult, especially when diagnostic ventricular pacing does not conduct to the atrium. Even in such a situation, critical diagnostic findings can be obtained by spontaneous premature ventricular contraction.
View Article and Find Full Text PDFA narrow complex tachycardia with a short HV interval: What is the mechanism?
Pacing Clin Electrophysiol
January 2025
Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
The case was a 15-year-old male with a history of paroxysmal supraventricular tachycardia refractory to medical therapy and prior catheter. A repeat electrophysiology study and catheter ablation were applied. Baseline AH and HV intervals were 100 and 55 ms during normal sinus rhythm (NSR), respectively.
View Article and Find Full Text PDFPurkinje-related ventricular tachycardia with upper septal and left posterior fascicular type in a patient of post-myocardial infarction.
HeartRhythm Case Rep
August 2024
Department of Cardiology, Yokohama City University School of Medicine, Yokohama, Japan.
Right Coronary Artery to Left Ventricular Fistula Complicated by Symptomatic Arrhythmia.
Cureus
June 2024
Adult Cardiology, King Faisal Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU.
Coronary cameral fistulas (CCFs) are rare and are characterized by an abnormal connection between a coronary artery and any of the four chambers of the heart. Most cases of CCFs are asymptomatic. The most common presentation in symptomatic patients includes chest pain or heart failure; however, arrhythmias are rarely associated.
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