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(Circulation. 1968;37:1015.)
© 1968 American Heart Association, Inc.

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Differentiation of Ventricular Tachycardia from Junctional Tachycardia with Aberrant Conduction

The Use of Competitive Atrial Pacing

ROBERT M. EASLEY JR. M.D.¹ SIDNEY GOLDSTEIN M.D.¹

¹ From the Department of Medicine of the Rochester General Hospital and the University of Rochester School of Medicine and Dentistry, Rochester, New York.

A case of regular tachycardia with an intraventricular conduction defect and possible retrograde P waves is reported. The condition was interpreted as being either ventricular tachycardia with 1 : 1 retrograde V-A conduction or an atrioventricular junctional tachycardia with aberrant intraventricular conduction. Atrial pacing resulted in normalization of intraventricular conduction as well as the production of fusion beats and allowed a definitive diagnosis of ventricular tachycardia. The use of atrial pacing as a diagnostic technique has not been previously discussed in the literature.

Key Words: Intra-atrial electrocardiogram • Quinidine therapy • Arrhythmias • Intraventricular conduction