Irregular wide QRS complex tachycardia in a patient with pulmonary hypertension: What is the mechanism?

Introduction Pulmonary hypertension (PH) results in right ventricular (RV) hypertrophy and dilation that could lead to the development of arrhythmogenic substrates for cardiac arrhythmias, which are important predictors and contributors to morbidity and mortality in these patients. To date, the mechanism of ventricular arrhythmia in patients with PH are less well understood. Here, we reported a case presenting sustained and nonsustained ventricular arrhythmia owing to the increased automaticity of the right Purkinje arborization in a patient with severe chronic PH and the promising effectiveness of radiofrequency catheter ablation in elimination of the ventricular arrhythmia.