Unusual Permanent Form of Junctional Reciprocating Tachycardia Associated With an Accessory Pathway With Bidirectional Conduction

We describe an unusual case of permanent form of junctional reciprocating tachycardia in a patient with manifest Wolff-Parkinson-White syndrome. The electrophysiological study revealed an accessory pathway responsible for the tachycardia, revealing fast and nondecremental anterograde conduction and slow and decremental retrograde conduction that was successfully ablated from the middle cardiac vein. (Level of Difficulty: Advanced.) [Display omitted] The authors describe an unusual case of a permanent form of junctional reciprocating tachycardia in a patient with manifest…