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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

Fluoroscopy during ablation of twin B. Left panel: the ablation catheter is at the point of maximal His recording. Right panel: the catheter is in the position where touch AV block and junctional tachycardia were produced.
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Figure 4: Fluoroscopy during ablation of twin B. Left panel: the ablation catheter is at the point of maximal His recording. Right panel: the catheter is in the position where touch AV block and junctional tachycardia were produced.

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)

Fluoroscopy during ablation of twin B. Left panel: the ablation catheter is at the point of maximal His recording. Right panel: the catheter is in the position where touch AV block and junctional tachycardia were produced.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Fluoroscopy during ablation of twin B. Left panel: the ablation catheter is at the point of maximal His recording. Right panel: the catheter is in the position where touch AV block and junctional tachycardia were produced.
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