Mechanisms of Posterior Fascicular Tachycardia
The Relationship Between High Frequency Potentials and the Ventricular Myocardium
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A 17-year-old man presented with a history of palpitations and surface ECG demonstrating wide QRS tachycardia (QRS duration=140 ms) with a right bundle branch block pattern and left-axis deviation (Figure 1A). The 12-lead ECG was normal during sinus rhythm.
See Editor’s Perspective by Asirvatham and Stevenson
During electrophysiology study, mapping was performed using a 20 pole multielectrode catheter (MEC) via a retrograde aortic approach (Figure 1C). The baseline A–H and H–V intervals were 57 and 55 ms, respectively (Figure 1B, left). A wide QRS tachycardia identical to the clinical tachycardia was observed with cycle length of 320 ms, H–V interval of −30 ms (Figure 1B, right). This was consistent with a diagnosis of …