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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

Mapping of the left lateral accessory pathway.* start of the RF energy application.Black arrow –points to the retrograde block.** change in retrograde atrial activation from eccentric to concentric (conduction over the AV node).
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fig4: Mapping of the left lateral accessory pathway.* start of the RF energy application.Black arrow –points to the retrograde block.** change in retrograde atrial activation from eccentric to concentric (conduction over the AV node).

Mentions: A slow pathway was localized and then ablated using radio-frequent (RF) catheter ablation (temperature controlled mode 50°C/30 W; Blazer II XP Standard curve, Boston Scientific, Massachusetts, USA), with slow-rate junctional rhythm observed during ablation and no signs of slow AV node pathway after ablation (ERP N antegrade 260 ms, antegrade suprahisian AV block <300 ms). After RF ablation, AVNRT could not be induced; however the AVRT was repeatedly induced without conversion to AVNRT. By performing a transseptal puncture of the interatrial septum guided by fluoroscopy, the left lateral wall AP was also successfully localized and then ablated using RF catheter ablation (temperature controlled mode 50°C/30 W; Blazer II XP Standard curve, Boston Scientific, Massachusetts, USA) (Fig. 4). During the RF ablation, retrograde AP conduction block was achieved.


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)

Mapping of the left lateral accessory pathway.* start of the RF energy application.Black arrow –points to the retrograde block.** change in retrograde atrial activation from eccentric to concentric (conduction over the AV node).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

fig4: Mapping of the left lateral accessory pathway.* start of the RF energy application.Black arrow –points to the retrograde block.** change in retrograde atrial activation from eccentric to concentric (conduction over the AV node).
Mentions: A slow pathway was localized and then ablated using radio-frequent (RF) catheter ablation (temperature controlled mode 50°C/30 W; Blazer II XP Standard curve, Boston Scientific, Massachusetts, USA), with slow-rate junctional rhythm observed during ablation and no signs of slow AV node pathway after ablation (ERP N antegrade 260 ms, antegrade suprahisian AV block <300 ms). After RF ablation, AVNRT could not be induced; however the AVRT was repeatedly induced without conversion to AVNRT. By performing a transseptal puncture of the interatrial septum guided by fluoroscopy, the left lateral wall AP was also successfully localized and then ablated using RF catheter ablation (temperature controlled mode 50°C/30 W; Blazer II XP Standard curve, Boston Scientific, Massachusetts, USA) (Fig. 4). During the RF ablation, retrograde AP conduction block was achieved.

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