RESUMEN
A 45-years-old lady with no structural heart disease on echocardiogram presented with recurrent episodes of palpitation. There was no baseline preexcitation. Twelve lead surface electrocardiograms (ECG) recorded during one of the episodes are provided. What is the likely mechanism of the tachycardia? [Figure: see text].
Asunto(s)
Taquicardia/diagnóstico , Taquicardia/fisiopatología , Diagnóstico Diferencial , Ecocardiografía , Electrocardiografía , Femenino , Humanos , Persona de Mediana EdadRESUMEN
A 32-year-old lady was evaluated for recurrent episodes of palpitation. During one of the palpitation episodes a regular narrow QRS tachycardia was documented, and it got terminated with the administration of IV adenosine. The baseline 12 lead electrocardiogram (ECG) did not show any manifest preexcitation. There was no evidence of structural heart disease by echocardiogram. Patient underwent an electrophysiology (EP) study after informed consent. Quadripolar catheters were placed at the His region and right ventricular (RV) apex. A decapolar catheter was placed in the coronary sinus (CS) with CS 9, 10 dipoles at CS OS region and CS 1, 2 dipoles at CS distal region. A mapping & ablation catheter was positioned at right atrial (RA) appendage. Baseline atrial and ventricular pacing protocols could not be performed as both atrial and ventricular pacing were easily inducing a regular narrow QRS tachycardia. His refractory premature ventricular beats [PVBs] were delivered from RVRV apex and left ventricular [LV] free wall. Discordant responses were obtained. What is the mechanism?
Asunto(s)
Sistema de Conducción Cardíaco/fisiopatología , Taquicardia/fisiopatología , Complejos Prematuros Ventriculares/fisiopatología , Adulto , Electrocardiografía , Mapeo Epicárdico , Femenino , HumanosRESUMEN
33 year old gentleman has undergone an electrophysiology study for recurrent paroxysmal palpitation. During one of the episodes of palpitation a regular narrow QRS tachycardia was documented which has terminated with intravenous adenosine. Baseline electrocardiogram did not show any pre-excitation. Atrial-His (AH) and His-Ventricular (HV) intervals were normal at baseline. There was no evidence of dual atrioventricular (AV) nodal physiology. Earliest atrial electrogram during ventricular pacing was recorded at coronary sinus (CS) 9,10 dipoles placed at CS OS region. Narrow QRS tachycardia with cycle length (TCL) of 400 ms and earliest retrograde atrial activation at CS 9,10 dipoles was induced with programmed ventricular stimulation. Ventricular overdrive (VOD) pacing was performed at 30 ms shorter than TCL during the tachycardia (Fig: 1). What is the mechanism of tachycardia?
RESUMEN
A 67-year-old female presented with history of recurrent palpitations. During one of the episodes of palpitation, a narrow QRS tachycardia was recorded and it was reported to be terminated with intravenous adenosine. The 12-lead electrocardiogram (ECG) showed no manifest ventricular preexcitation. ECG was within normal limits. The patient underwent an electrophysiology study after informed consent. She was taking calcium channel blockers and that was stopped five half-lives prior to the procedure. As catheters were being placed, a narrow QRS tachycardia got induced. During the study, there was development of right bundle branch block during the tachycardia. What is the mechanism of the tachycardia?
Asunto(s)
Electrocardiografía/métodos , Bloqueo Cardíaco/diagnóstico , Bloqueo Cardíaco/fisiopatología , Sistema de Conducción Cardíaco/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Anciano , Diagnóstico Diferencial , Femenino , HumanosAsunto(s)
Taquicardia por Reentrada en el Nodo Atrioventricular , Taquicardia Reciprocante , Taquicardia Supraventricular , Electrocardiografía , Humanos , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugía , Taquicardia Reciprocante/diagnóstico , Taquicardia Reciprocante/cirugíaAsunto(s)
Taquicardia por Reentrada en el Nodo Atrioventricular , Nodo Atrioventricular , Estimulación Cardíaca Artificial , Electrocardiografía , Ventrículos Cardíacos , Humanos , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugíaRESUMEN
A 50-year-old female presented with incessant palpitation of 2 weeks duration. She was hemodynamically stable and there was no evidence of heart failure. A transthoracic echocardiogram showed mild left ventricular (LV) dysfunction with LV ejection fraction of 45%. Electrocardiogram (12 lead and rhythm strip) was taken during the palpitation. What is the mechanism?
Asunto(s)
Fascículo Atrioventricular Accesorio/complicaciones , Fascículo Atrioventricular Accesorio/diagnóstico , Electrocardiografía/métodos , Taquicardia por Reentrada en el Nodo Atrioventricular/complicaciones , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana EdadAsunto(s)
Sistema de Conducción Cardíaco/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Adulto , Nodo Atrioventricular/fisiopatología , Ablación por Catéter , Diagnóstico Diferencial , Ecocardiografía , Electrocardiografía , Femenino , Sistema de Conducción Cardíaco/cirugía , Humanos , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugíaAsunto(s)
Potenciales de Acción , Nodo Atrioventricular/fisiopatología , Técnicas Electrofisiológicas Cardíacas , Frecuencia Cardíaca , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Técnicas de Ablación , Nodo Atrioventricular/cirugía , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugía , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Bloqueo Atrioventricular/fisiopatología , Estimulación Cardíaca Artificial/métodos , Ventrículos Cardíacos/fisiopatología , Marcapaso Artificial , Taquicardia/fisiopatología , Anciano , Bloqueo Atrioventricular/diagnóstico , Bloqueo Atrioventricular/terapia , Electrocardiografía/métodos , Femenino , Humanos , Taquicardia/diagnóstico , Taquicardia/terapiaAsunto(s)
Potenciales de Acción , Nodo Atrioventricular/fisiopatología , Técnicas Electrofisiológicas Cardíacas , Frecuencia Cardíaca , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Técnicas de Ablación , Adulto , Nodo Atrioventricular/cirugía , Femenino , Humanos , Valor Predictivo de las Pruebas , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugía , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Potenciales de Acción , Arritmias Cardíacas/diagnóstico , Fascículo Atrioventricular/fisiopatología , Electrocardiografía , Técnicas Electrofisiológicas Cardíacas , Frecuencia Cardíaca , Arritmias Cardíacas/fisiopatología , Arritmias Cardíacas/cirugía , Ablación por Catéter , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del TratamientoRESUMEN
A 62-year-old male was transferred to our hospital complaining of palpitations. His heart rate was 185/min. Electrocardiogram showed a narrow QRS regular tachycardia and the tachycardia changed spontaneously to another narrow QRS tachycardia with two alternating cycle lengths. The arrhythmia was stopped by the administration of adenosine triphosphate. Findings from electrophysiological study suggested that there was an accessory pathway (AP) and dual atrioventricular (AV) nodal pathways. After AP ablation, any other tachyarrythmias were not induced. We supposed that the tachycardia was paroxysmal supraventricular tachycardia involving AP and anterograde conduction alternating between slow and fast AV nodal pathways.
Asunto(s)
Ablación por Catéter , Taquicardia por Reentrada en el Nodo Atrioventricular , Taquicardia Ventricular , Masculino , Humanos , Persona de Mediana Edad , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugía , Nodo Atrioventricular/cirugía , ElectrocardiografíaAsunto(s)
Potenciales de Acción , Nodo Atrioventricular/fisiopatología , Frecuencia Cardíaca , Taquicardia Ventricular/fisiopatología , Técnicas de Ablación , Nodo Atrioventricular/cirugía , Estimulación Cardíaca Artificial , Electrocardiografía , Técnicas Electrofisiológicas Cardíacas , Humanos , Masculino , Persona de Mediana Edad , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/cirugía , Factores de Tiempo , Resultado del TratamientoRESUMEN
We present an atypical response to single atrial premature depolarization (APD) in a long RP' tachycardia. APD advanced the His-bundle potential immediately after it and resulted in a VA block; however, tachycardia persisted and consequently exhibited an A-V-V-A response. We propose the mechanism for an A-V-V-A response to APD in a long RP' tachycardia.