Narrow complex tachycardia with alternating atrial activation: What is the mechanism?

The article examines a clinical case of narrow complex tachycardia with alternating atrial activation in a 50-year-old male undergoing evaluation for a redo ablation procedure. Topics include the diagnostic considerations for alternating atrial activation; the electrophysiology study findings, including pre-excitation and narrow complex tachycardia with a VAHV response; and the challenges in managing arrhythmias complicated by prior ablation attempts and associated comorbidities.