Abstract
We report on a patient with supraventricular tachycardia, mediated through a left posterior concealed accessory pathway (AP). During an electrophysiology study, the His refractory premature ventricular complex (PVC) delayed in the next atrial signal and was suggestive of the decremental pathway; however, further maneuvers and tachycardia features were suggestive of a nondecremental AP. In this paper, we discuss possible mechanisms of this interesting observation of decremental response to PVC in an otherwise nondecremental AP.
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