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. 2002 Oct 1;2(4):120–126.

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Copyright: © 2002 Lam et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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WCT due to an SVT with left BBB aberrance. Note that the tachycardia is induced by ventricular stimulation with a single premature beat delivered at the right ventricular apex. After the third beat of tachycardia, the rhythm changed from WCT with left BBB morphology to a narrow complex tachycardia. On EP testing, this tachycardia was found to represent an orthodromic atrioventricular reciprocating tachycardia using a concealed left atrioventricular free-wall accessory pathway for its retrograde limb. The accessory pathway was successfully ablated, and the tachycardia could no longer be induced. The clue to the diagnosis of SVT with aberrance in this case is the presence of both narrow and wide complex tachycardias at nearly the same cycle lengths in the same patient. Paper speed is 75 mm/s.