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Patient
34-year-old man with no prior history, presenting palpitations; cardiac ultrasound without abnormality; recording of a tracing during an episode of palpitations;
Trace
Tachycardia of 140 bpm, regular, monomorphic, moderately broad QRS (130 ms), with right delay pattern, left axis; atrioventricular dissociation with atrial rate slower than ventricular rate (positive sinus activity in leads I, II, negative in aVR identifiable between certain QRS complexes);
Trace
Recorded after sinus return; tracing without abnormality;
Exergue
A fascicular ventricular tachycardia occurs preferentially in a young man without heart disease with a characteristic electrocardiographic pattern: monomorphic tachycardia, slightly widened QRS, right delay, left axis, atrioventricular dissociation
The recorded electrocardiogram corresponds to a typical pattern of fascicular ventricular tachycardia in a healthy heart. This type of tachycardia occurs preferentially in the young adult in absence of underlying cardiac disease with a male predominance.