A wide QRS complex tachycardia with different initiation patterns: What is the mechanism?

Takumi Yamada, Vance J. Plumb, Hugh T. Mcelderry, G. Neal Kay

Research output: Contribution to journalArticlepeer-review

Abstract

A 47-year-old man with palpitations underwent electrophysiologic testing (EPS). Burst atrial pacing while infusing isoproterenol induced non-reproducible wide QRS tachycardias with an unusual pattern of an H-A-V activation with the same tachycardia cycle length and two different initiation patterns. The tachycardia had the earliest atrial activation at the His bundle region. No dual atrioventricular (AV) nodal physiology was demonstrated by programmed atrial stimulation. Though a definite diagnosis of AV nodal reentrant tachycardia was not obtained, slow pathway ablation was performed in order to avoid inadvertent AV block as a complication. Thereafter, no tachycardias were induced by repeat burst atrial pacing.

Original languageEnglish (US)
Pages (from-to)796-798
Number of pages3
JournalPACE - Pacing and Clinical Electrophysiology
Volume30
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Keywords

  • Atrioventricular nodal reentrant tachycardia
  • Dual response
  • Radiofrequency catheter ablation
  • Slow pathway

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