[Unusual mechanism of reciprocating tachycardia in a case of ventricular preexcitation resistant to preventive anti-arrhythmia therapy].

A patient with a previously asymptomatic W.P.W. syndrome had, at the age of 60, frequent runs of paroxysmal tachycardia, which occurred particularly after meals. The paroxysms were easily controlled by pharmacological therapy in the acute stage, but could not be prevented by prophylactic therapy because of a large oesophageal diverticulum which, through right vagal reflexes, caused sinus arrests with junctional escapes that triggered the re-entry mechanism. Resection of the diverticulum abolished the tachycardia spells.