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An uncommon case of spontaneous conversion from AV re-entry tachycardia to AV nodal re-entry tachycardia in a patient with dual tachycardia.

Zeljković I, Benko I, Manola Š, Radeljić V, Pavlović N - Indian Pacing Electrophysiol J (2016)

Bottom Line: During the EP study, supraventricular tachycardia was induced easily and it corresponded to orthodromic AV reentry tachycardia (AVRT) using a concealed left free wall accessory pathway.However, during the study AVRT spontaneously and repeatedly converted to the typical slow-fast AV node reentry tachycardia (AVNRT).Both accessory and AV nodal slow pathways were ablated, due to the finding that both AVRT and AVNRT were independently inducible during the EP study.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Electrophysiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

ABSTRACT
We report the case of a 46-year old patient in whom an electrophysiology study (EP) was performed due to paroxysmal supraventricular tachycardia documented in 12-lead ECG. During the EP study, supraventricular tachycardia was induced easily and it corresponded to orthodromic AV reentry tachycardia (AVRT) using a concealed left free wall accessory pathway. However, during the study AVRT spontaneously and repeatedly converted to the typical slow-fast AV node reentry tachycardia (AVNRT). Both accessory and AV nodal slow pathways were ablated, due to the finding that both AVRT and AVNRT were independently inducible during the EP study.

No MeSH data available.


Related in: MedlinePlus

Spontaneous conversion from AV re-entry tachycardia to AV nodal re-entry tachycardia.Black arrows – show the retrograde conduction trough accessory pathway (eccentric atrial activation).* and ** show premature atrial contractions. The first one, marked with * did not affect the tachycardia while the other marked with ** found the fast pathway refractory and engaged the slow pathway initiating the AVNRT.Black discontinuous arrows – show the antegrade conduction trough slow AV node pathway.
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fig2: Spontaneous conversion from AV re-entry tachycardia to AV nodal re-entry tachycardia.Black arrows – show the retrograde conduction trough accessory pathway (eccentric atrial activation).* and ** show premature atrial contractions. The first one, marked with * did not affect the tachycardia while the other marked with ** found the fast pathway refractory and engaged the slow pathway initiating the AVNRT.Black discontinuous arrows – show the antegrade conduction trough slow AV node pathway.

Mentions: However, during the EP study the AVRT spontaneously converted (Fig. 2) to the typical slow-fast AVNRT (cycle length 360 ms), with characteristics: VA < 30 ms, PPI – TCL > 150 ms, jump noted at programmed pacing (500/280 ms) from right atrium as well as the echo beat.


An uncommon case of spontaneous conversion from AV re-entry tachycardia to AV nodal re-entry tachycardia in a patient with dual tachycardia.

Zeljković I, Benko I, Manola Š, Radeljić V, Pavlović N - Indian Pacing Electrophysiol J (2016)

Spontaneous conversion from AV re-entry tachycardia to AV nodal re-entry tachycardia.Black arrows – show the retrograde conduction trough accessory pathway (eccentric atrial activation).* and ** show premature atrial contractions. The first one, marked with * did not affect the tachycardia while the other marked with ** found the fast pathway refractory and engaged the slow pathway initiating the AVNRT.Black discontinuous arrows – show the antegrade conduction trough slow AV node pathway.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834425&req=5

fig2: Spontaneous conversion from AV re-entry tachycardia to AV nodal re-entry tachycardia.Black arrows – show the retrograde conduction trough accessory pathway (eccentric atrial activation).* and ** show premature atrial contractions. The first one, marked with * did not affect the tachycardia while the other marked with ** found the fast pathway refractory and engaged the slow pathway initiating the AVNRT.Black discontinuous arrows – show the antegrade conduction trough slow AV node pathway.
Mentions: However, during the EP study the AVRT spontaneously converted (Fig. 2) to the typical slow-fast AVNRT (cycle length 360 ms), with characteristics: VA < 30 ms, PPI – TCL > 150 ms, jump noted at programmed pacing (500/280 ms) from right atrium as well as the echo beat.

Bottom Line: During the EP study, supraventricular tachycardia was induced easily and it corresponded to orthodromic AV reentry tachycardia (AVRT) using a concealed left free wall accessory pathway.However, during the study AVRT spontaneously and repeatedly converted to the typical slow-fast AV node reentry tachycardia (AVNRT).Both accessory and AV nodal slow pathways were ablated, due to the finding that both AVRT and AVNRT were independently inducible during the EP study.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology and Electrophysiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.

ABSTRACT
We report the case of a 46-year old patient in whom an electrophysiology study (EP) was performed due to paroxysmal supraventricular tachycardia documented in 12-lead ECG. During the EP study, supraventricular tachycardia was induced easily and it corresponded to orthodromic AV reentry tachycardia (AVRT) using a concealed left free wall accessory pathway. However, during the study AVRT spontaneously and repeatedly converted to the typical slow-fast AV node reentry tachycardia (AVNRT). Both accessory and AV nodal slow pathways were ablated, due to the finding that both AVRT and AVNRT were independently inducible during the EP study.

No MeSH data available.


Related in: MedlinePlus