A 38‐year‐old woman was evaluated for a 2‐year history of intermit‐ tent palpitations. She had previously presented to the emergency room with wide complex SVT, which was terminated by intravenous… Click to show full abstract
A 38‐year‐old woman was evaluated for a 2‐year history of intermit‐ tent palpitations. She had previously presented to the emergency room with wide complex SVT, which was terminated by intravenous adenosine. In the electrophysiology laboratory, during the introduc‐ tion of the venous sheaths and catheters, the patient had sponta‐ neous sustained wide complex tachycardia with left bundle brunch block (LBBB) morphology. Responses to two different His‐refractory premature atrial complexes (PAC) from the lateral right atrium are given in Figure 1 (arrows in A and B). What is the mechanism of the tachycardia?
               
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