open access

Vol 63, No 10 (2005)
Other
Published online: 2005-10-21
Submitted: 2012-12-28
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Invasive electrophysiology
Tachycardia with rSr\'

Michał Orczykowski, Paweł Derejko, Ewa Szufladowicz, Robert Bodalski, Łukasz Szumowski, Piotr Urbanek, Roman Kępski, Agnieszka Maryniak, Franciszek Walczak
Kardiol Pol 2005;63(10):428-431.

open access

Vol 63, No 10 (2005)
Other
Published online: 2005-10-21
Submitted: 2012-12-28

Abstract

We present a case of a 15-year old girl in whom supraventricular tachycardia (SVT) with rSr’ pattern in lead V1 and the QRS width of less than 110 ms, suggesting typical slow-fast AVNRT, was the presenting arrhythmia. During sinus rhythm no preexcitation was observed. Considerable variability of the tachycardia cycle length (240-370 ms), attributable to the presence of the fast and slow nodal pathways, was also observed. However, during the electrophysiological study only orthodromic atrio-ventricular reciprocating tachycardia with the left-sided superior accessory pathway as the retrograde limb was documented. Thus, rSr’ pattern was due to incomplete right bundle branch block. We describe how the correct diagnosis and the site of the atrial insertion of the accessory pathway could be inferred from the careful analysis of the P’ wave morphology during the tachycardia.

Abstract

We present a case of a 15-year old girl in whom supraventricular tachycardia (SVT) with rSr’ pattern in lead V1 and the QRS width of less than 110 ms, suggesting typical slow-fast AVNRT, was the presenting arrhythmia. During sinus rhythm no preexcitation was observed. Considerable variability of the tachycardia cycle length (240-370 ms), attributable to the presence of the fast and slow nodal pathways, was also observed. However, during the electrophysiological study only orthodromic atrio-ventricular reciprocating tachycardia with the left-sided superior accessory pathway as the retrograde limb was documented. Thus, rSr’ pattern was due to incomplete right bundle branch block. We describe how the correct diagnosis and the site of the atrial insertion of the accessory pathway could be inferred from the careful analysis of the P’ wave morphology during the tachycardia.
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Keywords

supraventricular tachycardia differentiation; ablation

About this article
Title

Invasive electrophysiology
Tachycardia with rSr\' <110 ms in lead V1 – is it always an atrio-ventricular nodal tachycardia?

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 63, No 10 (2005)

Pages

428-431

Published online

2005-10-21

Bibliographic record

Kardiol Pol 2005;63(10):428-431.

Keywords

supraventricular tachycardia differentiation
ablation

Authors

Michał Orczykowski
Paweł Derejko
Ewa Szufladowicz
Robert Bodalski
Łukasz Szumowski
Piotr Urbanek
Roman Kępski
Agnieszka Maryniak
Franciszek Walczak

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