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Atrioventricular Nodal Re-entry Tachycardia in Identical Twins: A Case Report and Literature Review.

Barake W, Caldwell J, Baranchuk A - Indian Pacing Electrophysiol J (2013)

Bottom Line: Successful but technically challenging slow pathway ablation was performed in both twins.This is the first reported case of confirmed AVNRT in identical twins which adds strong evidence to heritability of the dual AV node physiology and AVNRT.A review of the current literature regarding PSVT in monozygotic twins is provided.

View Article: PubMed Central - PubMed

Affiliation: Heart Rhythm Service, Queen's University, Kingston, Ontario, Canada.

ABSTRACT
This report details the case of 17 year old identical twins who both presented with paroxysmal supraventricular tachycardia (PSVT). Electrophysiological studies revealed atrioventricular nodal reentry tachycardia (AVNRT) in both twins. Successful but technically challenging slow pathway ablation was performed in both twins. This is the first reported case of confirmed AVNRT in identical twins which adds strong evidence to heritability of the dual AV node physiology and AVNRT. A review of the current literature regarding PSVT in monozygotic twins is provided.

No MeSH data available.


Related in: MedlinePlus

Intracardiac recordings during mapping at the slow pathway region in twin B. Junctional tachycardia with dissociated atrial and ventricular activity was observed on touch alone.
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Figure 3: Intracardiac recordings during mapping at the slow pathway region in twin B. Junctional tachycardia with dissociated atrial and ventricular activity was observed on touch alone.

Mentions: Twin B: Baseline intervals were normal (Table 1). Retrograde testing showed a decremental, concentric VA conduction with AV node ERP of 240 msec. Antegrade conduction was decremental with FPERP 390ms and SPERP 240ms on a 600 ms train. Isoprenaline was infused at 2 mcg/min and AVNRT was induced by burst pacing. We therefore proceeded to slow pathway ablation. Successful slow pathway ablation was obtained after 9 RF applications and the procedure was fraught with difficulties; both transient AV block and junctional tachycardia were produced by touching the slow pathway area (Figure 3) even though this was distant from the maximal His recording (Figure 4).


Atrioventricular Nodal Re-entry Tachycardia in Identical Twins: A Case Report and Literature Review.

Barake W, Caldwell J, Baranchuk A - Indian Pacing Electrophysiol J (2013)

Intracardiac recordings during mapping at the slow pathway region in twin B. Junctional tachycardia with dissociated atrial and ventricular activity was observed on touch alone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539401&req=5

Figure 3: Intracardiac recordings during mapping at the slow pathway region in twin B. Junctional tachycardia with dissociated atrial and ventricular activity was observed on touch alone.
Mentions: Twin B: Baseline intervals were normal (Table 1). Retrograde testing showed a decremental, concentric VA conduction with AV node ERP of 240 msec. Antegrade conduction was decremental with FPERP 390ms and SPERP 240ms on a 600 ms train. Isoprenaline was infused at 2 mcg/min and AVNRT was induced by burst pacing. We therefore proceeded to slow pathway ablation. Successful slow pathway ablation was obtained after 9 RF applications and the procedure was fraught with difficulties; both transient AV block and junctional tachycardia were produced by touching the slow pathway area (Figure 3) even though this was distant from the maximal His recording (Figure 4).

Bottom Line: Successful but technically challenging slow pathway ablation was performed in both twins.This is the first reported case of confirmed AVNRT in identical twins which adds strong evidence to heritability of the dual AV node physiology and AVNRT.A review of the current literature regarding PSVT in monozygotic twins is provided.

View Article: PubMed Central - PubMed

Affiliation: Heart Rhythm Service, Queen's University, Kingston, Ontario, Canada.

ABSTRACT
This report details the case of 17 year old identical twins who both presented with paroxysmal supraventricular tachycardia (PSVT). Electrophysiological studies revealed atrioventricular nodal reentry tachycardia (AVNRT) in both twins. Successful but technically challenging slow pathway ablation was performed in both twins. This is the first reported case of confirmed AVNRT in identical twins which adds strong evidence to heritability of the dual AV node physiology and AVNRT. A review of the current literature regarding PSVT in monozygotic twins is provided.

No MeSH data available.


Related in: MedlinePlus