open access

Vol 66, No 8 (2008)
Other
Published online: 2008-08-27
Submitted: 2012-12-28
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Invasive electrophysiology
A long RP tachycardia – an electrophysiological puzzle

Marek Jastrzębski
Kardiol Pol 2008;66(8):909-914.

open access

Vol 66, No 8 (2008)
Other
Published online: 2008-08-27
Submitted: 2012-12-28

Abstract

A case of a 30-year-old male with paroxysmal long RP tachycardia is presented. During electrophysiological study the clinical arrhythmia (atypical atrioventricular nodal reentrant tachycardia – AVNRT) was misdiagnosed as ectopic left atrial tachycardia due to ventricle-atrium-atrium-ventricle (VAAV) response after entrainment, eccentric atrial activation sequence and easiness in achieving atrio-ventricular dissociation with ventricular pacing during the tachycardia. Reassessment of the VAAV response lead to recognition of pseudo-VAAV response often seen in atypical, fast-slow AVNRT. Subsequent ablation of the slow pathway at standard site in the triangle of Koch was successful in eliminating the tachycardia.

Abstract

A case of a 30-year-old male with paroxysmal long RP tachycardia is presented. During electrophysiological study the clinical arrhythmia (atypical atrioventricular nodal reentrant tachycardia – AVNRT) was misdiagnosed as ectopic left atrial tachycardia due to ventricle-atrium-atrium-ventricle (VAAV) response after entrainment, eccentric atrial activation sequence and easiness in achieving atrio-ventricular dissociation with ventricular pacing during the tachycardia. Reassessment of the VAAV response lead to recognition of pseudo-VAAV response often seen in atypical, fast-slow AVNRT. Subsequent ablation of the slow pathway at standard site in the triangle of Koch was successful in eliminating the tachycardia.
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Keywords

entrainment; atypical atrioventricular nodal reentrant tachycardia; pseudo-VAAV response; ablation

About this article
Title

Invasive electrophysiology
A long RP tachycardia – an electrophysiological puzzle

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 8 (2008)

Pages

909-914

Published online

2008-08-27

Bibliographic record

Kardiol Pol 2008;66(8):909-914.

Keywords

entrainment
atypical atrioventricular nodal reentrant tachycardia
pseudo-VAAV response
ablation

Authors

Marek Jastrzębski

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