Question: A month ago I was diagnosed with posterior fascicular ventricular tachycardia with a wide QRS of 0.13. I have been told that I should not do intense sports and that I should have an electrophysiological study and, if necessary, an ablation. I wonder why before trying the ablation they don't try medication. I am concerned that the test may have side effects that make me worse than I am right now. José Luis (Madrid).
Answer: The differentiation between the arrhythmias you mention is very difficult to do without an electrophysiological study. This study, carried out in centers with experience, is a very low-risk procedure in which the patient is applied local anesthesia in the puncture area (veins and / or arteries) and catheters (thin, long and flexible cables) are inserted. that are directed to the heart by means of X-rays or other types of location systems that do not require radiation (Navex © system) to cause the arrhythmia and see how electricity is distributed within it. In addition, apart from the diagnosis, an ablation can be performed, which is usually curative and is also low risk (certainly technically easier than atrial fibrillation ablation).