A healthy 11-year-old girl was referred to our center because of dyspnea and palpitations for several weeks. A transthoracic echocardiography demonstrated a left ventricular ejection fraction of 35%. Electrocardiograms were taken and showed incessant wide QRS complex tachycardia regularly interrupted by a narrow QRS complex. A closer inspection revealed repeating similar cycles, each consisting of 4 complexes. What is the mechanism of this phenomenon?
Le Polain De Waroux, J.-B., Gonzalez, M. C., Marchandise, S., & Scavée, C. (2013). A Wide QRS Complex Tachycardia and Group Beating in a Young Patient with Heart Failure: What Is the Mechanism? Journal of Cardiovascular Electrophysiology, 24(2), 231-232 (2013 feb). https://doi.org/10.1111/j.1540-8167.2012.02411.x (Original work published 2013)