This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kassotis, J. Articles by Reddy, C.V.R. Search for Related Content PubMed PubMed Citation Articles by Kassotis, J. Articles by Reddy, C.V.R. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB VERAPAMIL HYDROCHLORIDE Social Bookmarking                         What's this?

Adenosine-Sensitive Wide-Complex Tachycardia: An Uncommon Variant of Idiopathic Fascicular Ventricular Tachycardia

A Case Report

Clinical Electrophysiologic Services, Division of Cardiology, New York Methodist Hospital, Clinical Affiliate of the NY Presbyterian Hospital System, Brooklyn, NY.

Todd Slesinger, MD

Emergency Department, New York Methodist Hospital, Clinical Affiliate of the NY Presbyterian Hospital System, Brooklyn, NY.

Emir Festic, MD

Department of Medicine, New York Methodist Hospital, Clinical Affiliate of the NY Presbyterian Hospital System, Brooklyn, NY.

Louis Voigt, MD

Department of Medicine, New York Methodist Hospital, Clinical Affiliate of the NY Presbyterian Hospital System, Brooklyn, NY.

C.V.R. Reddy, MD, FACC

Division of Cardiology, Department of Medicine, New York Methodist Hospital, Clinical Affiliate of the NY Presbyterian Hospital System, Brooklyn, NY.

Most wide-complex tachycardias encountered in the emergency department (ED) are ventric ular in origin, most commonly associated with structural heart disease. Ventricular tach yarrhythmias range in severity from life-threatening rhythms (eg, ventricular fibrillation and hemodynamically compromising ventricular tachycardia [VT]) to idiopathic forms of VT, which have a benign clinical course and a more favorable prognosis. The authors present the case of a 34-year-old woman who presented to the ED, with a wide-complex tachycardia with a right- bundle-branch block (RBBB) morphology and a right inferior axis, which was terminated with adenosine. The patient was previously misdiagnosed as suffering from a paroxysmal supraven tricular tachycardia (SVT), which was unresponsive to beta-blocker therapy. Although the tachycardia responded to adenosine, suggestive of an SVT, the patient was referred to the arrhythmia service, where further work-up revealed an uncommon form of an idiopathic VT, originating from the left anterior fascicle. The authors discuss the unique electrocardiographic and electrophysiologic properties and useful diagnostic maneuvers required to properly identify this form of VT.

Angiology, Vol. 54, No. 3, 369-372 (2003)
DOI: 10.1177/000331970305400315


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?