Interesting Case of Narrow QRS tachycardia with A-V dissociation

Publication date: Available online 3 April 2018 Source:Journal of the Saudi Heart Association Author(s): Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Hiren Kevadiya, Ajitkumar Valaparambil A 30 year old gentleman with no structural heart disease has been evaluated for paroxysmal palpitation with documented regular narrow QRS tachycardia that has not responded to IV adenosine. Surface electrocardiogram has not shown any pre-excitation. He has been taken for an EP study after informed consent. Diagnostic catheters were placed at coronary sinus (CS), His bundle region and right ventricle (RV). During catheter manipulation a regular narrow QRS tachycardia with incomplete right bundle branch block morphology (RBBB) and normal QRS axis similar to the clinical tachycardia got induced. No other tachycardia was induced. What is the mechanism of tachycardia?
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research