@misc{cogprints4190, volume = {4}, number = {3}, month = {July}, author = {Johnson Francis and Venugopal K and Khadar SA and Sudhayakumar N and Anoop K Gupta}, editor = {Balbir Singh and Yash Lokhandwala and Johnson Francis and Anup Gupta}, title = {Idiopathic Fascicular Ventricular Tachycardia }, publisher = {Indian Pacing and Electrophysiology Group}, year = {2004}, journal = {Indian Pacing and Electrophysiology Journal}, pages = {98--103}, keywords = {Ventricular Tachycardia, Structural Normal Heart, Radiofrequency ablation }, url = {http://cogprints.org/4190/}, abstract = {Idiopathic fascicular ventricular tachycardia is an important cardiac arrhythmia with specific electrocardiographic features and therapeutic options. It is characterized by relatively narrow QRS complex and right bundle branch block pattern. The QRS axis depends on which fascicle is involved in the re-entry. Left axis deviation is noted with left posterior fascicular tachycardia and right axis deviation with left anterior fascicular tachycardia. A left septal fascicular tachycardia with normal axis has also been described. Fascicular tachycardia is usually seen in individuals without structural heart disease. Response to verapamil is an important feature of fascicular tachycardia. Rare instances of termination with intravenous adenosine have also been noted. A presystolic or diastolic potential preceding the QRS, presumed to originate from the Purkinje fibers can be recorded during sinus rhythm and ventricular tachycardia in many patients with fascicular tachycardia. This potential (P potential) has been used as a guide to catheter ablation. Prompt recognition of fascicular tachycardia especially in the emergency department is very important. It is one of the eminently ablatable ventricular tachycardias. Primary ablation has been reported to have a higher success, lesser procedure time and fluoroscopy time. } }