Post on 27-May-2015
Wide QRS Tachycardia with Two Different P Waves,
WHAT IS THE MECHANISM ?Paul Wei Hua Tang, Kun Tai Lee, Wei Chung Tsai, Wen De Lai
Kaoshiung Medical University Hospital
Brief History
• 38 years old male without any systemic disease or regular medication
• Complained of palpitation frequently during past few months
• Tachycardia with stable vital sign during palpitation at emergency room
Differential Diagnosis
• Multifocal atrial tachycardia with aberrantconduction
• Ventricular tachycardia with AV dissociationwith frequent atrial premature complex
• Ventricular tachycardia with sinus P wave andretrograde VA conduction P wave
Laboratory Data and Echo Data
• Normal electrolytes
• Normal cardiac echo findings No structural heart disease
Tachycardia Surface EKG
Tachycardia Intracardiac Electrogram
• No antegrade or retrograde dual AV node properties
• Ventricular electrical activity predominant • Zero HV interval
Idiopathic Left Ventricular Tachycardia
Diastolic Potentials at Successful Ablation Site
Thank You for Attention