on narrow complex QRS tachycardia with heart rate around 190–200 beats/min and atrioventricular (AV) dissociation with ventricular rate faster than atrial rate [Figure 1a]. Echocardiogram revealed a moderate left ventricular… Click to show full abstract
on narrow complex QRS tachycardia with heart rate around 190–200 beats/min and atrioventricular (AV) dissociation with ventricular rate faster than atrial rate [Figure 1a]. Echocardiogram revealed a moderate left ventricular (LV) dysfunction with ejection fraction of 40% and an otherwise structurally normal heart. Her initial medication included appropriate dosages of amiodarone, propranolol, flecainide, and enalapril. Her heart rate was controlled to 170 beats/min but the arrhythmia continued.
               
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