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Abstract
Serial electrophysiologic studies were performed in a patient with recurrent ventricular
tachycardia of left bundle branch configuration whose course and noninvasive evaluation
are consistent with a diagnosis of right ventricular dysplasia. The localization of
slowed conduction to the right ventricular apex, the reproducible initiation and termination
of tachycardia with programmed extrastimuli and the presence of continuous electrical
activity during tachycardia suggest a reentrant mechanism for this arrhythmia. Antiarrhythmic
drugs further prolong the already fragmented apical electrogram and result in Wenckebach
conduction within the abnormal portion of the right ventricle during pacing and tachycardia.
Electrophysiologic findings are remarkably similar in studies performed 32 months
apart.