PubMed · 1141692
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J C Bailey. 1975. Right bundle branch block.. https://pubmed.ncbi.nlm.nih.gov/1141692/
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Congenital junctional ectopic tachycardia is an uncommon and potentially fatal arrhythmia that does not usually respond to medical therapy. We report a two month old infant with severe ventricular failure. The diagnosis was confirmed by electrophysiologic study. She underwent endocardial cryoablation of the His bundle during extracorporeal circulation and a ventricle epicardial-lead pacemaker was implanted. Eight years later the patient is still symptom-free without needing medical treatment.
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Two wide QRS tachycardias with identical morphology but different cycle lengths (CLs) developed in a 63-year-old man. Electrophysiological study demonstrated inducible atrioventricular reentrant tachycardia (AVRT) due to a concealed left posterior accessory pathway (AP), which was successfully ablated by radiofrequency application. Neither dual AV nodal pathways nor other APs were documented. Splitting of the His-bundle electrogram was shown, and programmed stimulation induced sudden prolongation of intra-hisian conduction time. These results suggest longitudinal dissociation in the His bundle may be responsible for two distinct CLs in AVRT without dual AV nodal physiology.