open access

Vol 66, No 5 (2008)
Other
Published online: 2008-05-26
Submitted: 2012-12-28
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Invasive electrophysiology
Role of the AV node and adrenergic stimulation in initiation of fascicular and atrioventricular nodal tachycardias – a case report

Łukasz Szumowski, Maria Miszczak-Knecht, Katarzyna Bieganowska, Joanna Rękawek, Elżbieta Szymaniak, Wanda Kawalec, Franciszek Walczak
Kardiol Pol 2008;66(5):588-593.

open access

Vol 66, No 5 (2008)
Other
Published online: 2008-05-26
Submitted: 2012-12-28

Abstract

Fascicular tachycardia is an uncommon form of left ventricular tachycardia in young patients with normal heart. Ventriculo-atrial conduction during VT is usually absent. Retrograde conduction was observed in a 14-year old boy with left posterior fascicular VT (LPF-VT) triggered by exercise. During isoproterenol infusion, atrial stimulation induced a cascade of arrhythmias – echo, pair or runs of AVNRT and fascicular tachycardia triggered by fascicular beats. Also, during infusion LPF-VT was initiated spontaneously. After successful ablation of VT, sustained typical AVNRT was inducible. Finally, ablation of slow pathway of AV node was performed. After ablation,no arrhythmia was inducible following isoproterenol and exercise.

Abstract

Fascicular tachycardia is an uncommon form of left ventricular tachycardia in young patients with normal heart. Ventriculo-atrial conduction during VT is usually absent. Retrograde conduction was observed in a 14-year old boy with left posterior fascicular VT (LPF-VT) triggered by exercise. During isoproterenol infusion, atrial stimulation induced a cascade of arrhythmias – echo, pair or runs of AVNRT and fascicular tachycardia triggered by fascicular beats. Also, during infusion LPF-VT was initiated spontaneously. After successful ablation of VT, sustained typical AVNRT was inducible. Finally, ablation of slow pathway of AV node was performed. After ablation,no arrhythmia was inducible following isoproterenol and exercise.
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Keywords

cascade of arrhythmias; catecholaminergic left posterior fascicular VT; AVNRT; ablation

About this article
Title

Invasive electrophysiology
Role of the AV node and adrenergic stimulation in initiation of fascicular and atrioventricular nodal tachycardias – a case report

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 66, No 5 (2008)

Pages

588-593

Published online

2008-05-26

Bibliographic record

Kardiol Pol 2008;66(5):588-593.

Keywords

cascade of arrhythmias
catecholaminergic left posterior fascicular VT
AVNRT
ablation

Authors

Łukasz Szumowski
Maria Miszczak-Knecht
Katarzyna Bieganowska
Joanna Rękawek
Elżbieta Szymaniak
Wanda Kawalec
Franciszek Walczak

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