Antidromic atrioventricular reentrant tachycardia in a patient with Wolff‐Parkinson‐White syndrome and unapparent preexcitation: A case report

Abstract

A 50-year-old man with WPW syndrome with unapparent ventricular preexcitation has been suffering from palpitating attacks since his teenage years (Figure 1). He experienced tachycardia that lasted <15 minutes and stopped with breath holding. Thus, his electrocardiogram (ECG) at the time of the attack was not captured.A 12-lead ECG at the time of entering the catheter room transiently recognized ventricular preexcitation. An electrophysiological study was conducted using decapolar catheters positioned into coronary sinus (CS) and the His bundle and a quadripolar catheter positioned at the right ventricle.Ventricular preexcitation disappeared with burst pacing of 500 ms from CS and was not observed even with 400 ms (Figure 2A).Wide QRS tachycardia occurred with reproducibility with a pacing of 360 ms (Figure 2B) applied.