Radiofrequency catheter ablation of coexistent atrioventricular reciprocating tachycardia and left ventricular tachycardia originating in the left anterior fascicle

Coexistence of supraventricular tachycardia and ventricular tachycardia is rare. A patient with no structural heart disease and wide QRS complex tachy cardia with a right bundle block configuration and right-axis deviation und erwent electrophysiological examination. A concealed left atrioventricular pathway (AP) was found, and atrioventricular reciprocating tachycardia (AVR T) and left ventricular tachycardia (VT) originating in or close to the ant erior fascicle of the left ventricle were both induced. Radiofrequency (RF) catheter ablation of the concealed left AP was successfully performed. Ten months later, VT recurred and was successfully ablated using a local Purki nje potential as a guide. Coexistent AVRT and idiopathic VT originating fro m within or near the left anterior fascicle were successfully ablated.