Exercise-induced wide QRS complex tachycardia in a healthy middle-aged individual.

Idiopathic right ventricular outflow tract tachycardia (RVOT) of the Gallavardin type is a form of repetitive monomorphic ventricular tachycardia that typically occurs under adrenergic stimulation. Herein, we describe a typical presentation in a healthy, physically active man.The patient reported intermittent retrosternal tightness, palpitations and weakness during intense physical exertion. A 12-lead Holter-ECG repeatedly showed exercise-induced wide QRS-complex tachycardia with an inferior axis, left bundle branch block morphology and a presumed origin in the RVOT. After exclusion of structural heart disease by echocardiogram and unsuccessful antiarrhythmic therapy with verapamil, an electrophysiological study followed by catheter ablation was successfully performed. The patient remained asymptomatic.