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A case of 'tachy-brady syndrome': What is the mechanism?

Namboodiri N, Bohora S, Ajitkumar VK, Tharakan JA - Indian Pacing Electrophysiol J (2016)

Bottom Line: A young male presented with incessant narrow QRS tachycardia and left ventricular dysfunction. 24-Holter monitoring revealed multiple episodes of sustained and nonsustained episodes of tachycardia with prolonged sinus pauses at termination.The analysis of the electrocardiogram, followed by an invasive electrophysiological study, suggested an unusual mechanism for this tachy-brady syndrome.

View Article: PubMed Central - PubMed

Affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.

ABSTRACT
A young male presented with incessant narrow QRS tachycardia and left ventricular dysfunction. 24-Holter monitoring revealed multiple episodes of sustained and nonsustained episodes of tachycardia with prolonged sinus pauses at termination. The analysis of the electrocardiogram, followed by an invasive electrophysiological study, suggested an unusual mechanism for this tachy-brady syndrome.

No MeSH data available.


Related in: MedlinePlus

A) 12-lead ECG showing the long RP tachycardia initiated by a sinus beat. The first sinus beat is followed by a non-conducted atrial echo beat. B) Rhythm strips (lead II) showing the onset and termination of the nonsustained episodes of tachycardia. C) Holter showing episodes of tachycardia interspersed with sinus pauses.
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fig1: A) 12-lead ECG showing the long RP tachycardia initiated by a sinus beat. The first sinus beat is followed by a non-conducted atrial echo beat. B) Rhythm strips (lead II) showing the onset and termination of the nonsustained episodes of tachycardia. C) Holter showing episodes of tachycardia interspersed with sinus pauses.

Mentions: An 18-year old male presented with recurrent palpitations associated with occasional presyncope for the preceding 3 months. Nonsustained episodes of narrow QRS tachycardia with sinus pauses at termination were noted on the electrocardiogram (ECG) (Fig. 1A & B). Holter monitoring showed sustained and nonsustained episodes of tachycardia, with a cumulative duration of 14 h in a 24-h recording, and intervening sinus pauses (Fig. 1C) lasting up to 4.5 s. His left ventricular ejection fraction was 35% at presentation.


A case of 'tachy-brady syndrome': What is the mechanism?

Namboodiri N, Bohora S, Ajitkumar VK, Tharakan JA - Indian Pacing Electrophysiol J (2016)

A) 12-lead ECG showing the long RP tachycardia initiated by a sinus beat. The first sinus beat is followed by a non-conducted atrial echo beat. B) Rhythm strips (lead II) showing the onset and termination of the nonsustained episodes of tachycardia. C) Holter showing episodes of tachycardia interspersed with sinus pauses.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834438&req=5

fig1: A) 12-lead ECG showing the long RP tachycardia initiated by a sinus beat. The first sinus beat is followed by a non-conducted atrial echo beat. B) Rhythm strips (lead II) showing the onset and termination of the nonsustained episodes of tachycardia. C) Holter showing episodes of tachycardia interspersed with sinus pauses.
Mentions: An 18-year old male presented with recurrent palpitations associated with occasional presyncope for the preceding 3 months. Nonsustained episodes of narrow QRS tachycardia with sinus pauses at termination were noted on the electrocardiogram (ECG) (Fig. 1A & B). Holter monitoring showed sustained and nonsustained episodes of tachycardia, with a cumulative duration of 14 h in a 24-h recording, and intervening sinus pauses (Fig. 1C) lasting up to 4.5 s. His left ventricular ejection fraction was 35% at presentation.

Bottom Line: A young male presented with incessant narrow QRS tachycardia and left ventricular dysfunction. 24-Holter monitoring revealed multiple episodes of sustained and nonsustained episodes of tachycardia with prolonged sinus pauses at termination.The analysis of the electrocardiogram, followed by an invasive electrophysiological study, suggested an unusual mechanism for this tachy-brady syndrome.

View Article: PubMed Central - PubMed

Affiliation: Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.

ABSTRACT
A young male presented with incessant narrow QRS tachycardia and left ventricular dysfunction. 24-Holter monitoring revealed multiple episodes of sustained and nonsustained episodes of tachycardia with prolonged sinus pauses at termination. The analysis of the electrocardiogram, followed by an invasive electrophysiological study, suggested an unusual mechanism for this tachy-brady syndrome.

No MeSH data available.


Related in: MedlinePlus