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Radiofrequency ablation in a patient with atrioventricular reentrant tachycardia and atrioventricular nodal reentrant tachycardia with 2:1 atrioventricular block.
Rev Port Cardiol. 2002 Nov; 21(11):1319-26.RP

Abstract

The authors report the case of 15-year-old girl with a history of palpitations and shortness of breath during exercise. The electrocardiogram showed ventricular preexcitation suggesting a Wolff-Parkinson-White syndrome with a posteroseptal accessory pathway. During the electrophysiological study a left posterospetal accessory pathway was identified and an orthodromic atrioventricular reentry tachycardia was reproducibly induced (cycle length 400 ms). After disappearance of the ventricular pre-excitation with radiofrequency ablation, a dual physiology of atrioventricular node condution was documented and a slow-fast atrioventricular nodal reentrant tachycardia was repeatedly induced. Upon induction, this tachycardia presented a proximal atrioventricular block with 2:1 condution converted to 1:1 condution with overdrive pacing from the proximal coronary sinus (cycle length 270 ms). Radiofrequency ablation of the slow pathway was performed with success. We discuss the need to suspect and seek different arrhythmogenic substracts of tachycardia in a single patient, the electrophysiologic conditions that could explain the inducibility of different arrhythmias in this case, and the controversy regarding ablation of more than one reentry circuit in a single procedure.

Authors+Show Affiliations

University of Insubria, Department of Cardiovascular Sciences, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng por

PubMed ID

12564083

Citation

Oliveira, Mário, et al. "Radiofrequency Ablation in a Patient With Atrioventricular Reentrant Tachycardia and Atrioventricular Nodal Reentrant Tachycardia With 2:1 Atrioventricular Block." Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, vol. 21, no. 11, 2002, pp. 1319-26.
Oliveira M, de Ponti R, Trito M, et al. Radiofrequency ablation in a patient with atrioventricular reentrant tachycardia and atrioventricular nodal reentrant tachycardia with 2:1 atrioventricular block. Rev Port Cardiol. 2002;21(11):1319-26.
Oliveira, M., de Ponti, R., Trito, M., Spadacini, G., & Uriarte, J. S. (2002). Radiofrequency ablation in a patient with atrioventricular reentrant tachycardia and atrioventricular nodal reentrant tachycardia with 2:1 atrioventricular block. Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, 21(11), 1319-26.
Oliveira M, et al. Radiofrequency Ablation in a Patient With Atrioventricular Reentrant Tachycardia and Atrioventricular Nodal Reentrant Tachycardia With 2:1 Atrioventricular Block. Rev Port Cardiol. 2002;21(11):1319-26. PubMed PMID: 12564083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency ablation in a patient with atrioventricular reentrant tachycardia and atrioventricular nodal reentrant tachycardia with 2:1 atrioventricular block. AU - Oliveira,Mário, AU - de Ponti,Roberto, AU - Trito,Massimo, AU - Spadacini,Giammario, AU - Uriarte,Jorge Salerno, PY - 2003/2/5/pubmed PY - 2003/9/30/medline PY - 2003/2/5/entrez SP - 1319 EP - 26 JF - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JO - Rev Port Cardiol VL - 21 IS - 11 N2 - The authors report the case of 15-year-old girl with a history of palpitations and shortness of breath during exercise. The electrocardiogram showed ventricular preexcitation suggesting a Wolff-Parkinson-White syndrome with a posteroseptal accessory pathway. During the electrophysiological study a left posterospetal accessory pathway was identified and an orthodromic atrioventricular reentry tachycardia was reproducibly induced (cycle length 400 ms). After disappearance of the ventricular pre-excitation with radiofrequency ablation, a dual physiology of atrioventricular node condution was documented and a slow-fast atrioventricular nodal reentrant tachycardia was repeatedly induced. Upon induction, this tachycardia presented a proximal atrioventricular block with 2:1 condution converted to 1:1 condution with overdrive pacing from the proximal coronary sinus (cycle length 270 ms). Radiofrequency ablation of the slow pathway was performed with success. We discuss the need to suspect and seek different arrhythmogenic substracts of tachycardia in a single patient, the electrophysiologic conditions that could explain the inducibility of different arrhythmias in this case, and the controversy regarding ablation of more than one reentry circuit in a single procedure. SN - 0870-2551 UR - https://www.unboundmedicine.com/medline/citation/12564083/Radiofrequency_ablation_in_a_patient_with_atrioventricular_reentrant_tachycardia_and_atrioventricular_nodal_reentrant_tachycardia_with_2:1_atrioventricular_block_ DB - PRIME DP - Unbound Medicine ER -