A rare mechanism of tachycardia and aberrancy

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HeartRhythm Case Reports

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A rare mechanism of tachycardia and aberrancy Hemanth Ramanna, MD, PhD, Vincent J. van Driel, MD, PhD, Harry van Wessel, BSc, Richard N. Hauer, MD, PhD, Arnaud D. Hauer, MD, PhD HeartRhythm Case Reports Volume 4, Issue 10, Pages 447-450 (October 2018) DOI: 10.1016/j.hrcr.2018.06.011 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Twelve-lead electrocardiogram. A: at rest; B: during exercise. HeartRhythm Case Reports 2018 4, 447-450DOI: (10.1016/j.hrcr.2018.06.011) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Ladder diagram at rest (upper panel) and during exercise (lower panel). A = atrium; AV = atrioventricular node; F = fast pathway; S = slow pathway; V = ventricle. * indicates P wave during exercise. HeartRhythm Case Reports 2018 4, 447-450DOI: (10.1016/j.hrcr.2018.06.011) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Position of catheters (radiograph and NavX) in relation to the bundle of His (blue dots). Surface electrocardiogram leads and endocardial electrograms of right bundle (RBd-RB11-12), His bundle (HBE), His bundle unipolar (HBE uni), coronary sinus (CS), and right ventricular apex (RVA). See text for explanation. RAO = right anterior oblique. HeartRhythm Case Reports 2018 4, 447-450DOI: (10.1016/j.hrcr.2018.06.011) Copyright © 2018 Heart Rhythm Society Terms and Conditions