RESUMEN
INTRODUCTION: Although uncommonly encountered, dual atrioventricular nodal non-reentrant tachycardia (DAVNNRT) is a well-described arrhythmia that can manifest in patients with dual atrioventricular nodal pathways physiology. This arrhythmia is characterized on electrocardiogram (ECG) by a single P wave followed by two conducted QRS complexes (so-called "double fire"), and on intracardiac electrograms by a single atrial electrogram followed by two separate His deflections and ventricular electrograms. METHODS/RESULTS: We report a rare case of "triple-fire" atrioventricular non-reentrant tachycardia in which a patient was found to have three distinct atrioventricular nodal pathways and multiple triple fire responses, both on surface ECG and intracardiac electrograms. CONCLUSION: Multiple pathways physiology and it's clinical ramifications are discussed.
Asunto(s)
Taquicardia por Reentrada en el Nodo Atrioventricular , Taquicardia Supraventricular , Nodo Atrioventricular/cirugía , Electrocardiografía , Técnicas Electrofisiológicas Cardíacas , Humanos , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugíaAsunto(s)
Potenciales de Acción , Técnicas Electrofisiológicas Cardíacas , Sistema de Conducción Cardíaco/fisiopatología , Frecuencia Cardíaca , Complejos Prematuros Ventriculares/diagnóstico , Ablación por Catéter , Sistema de Conducción Cardíaco/cirugía , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Tiempo , Complejos Prematuros Ventriculares/fisiopatología , Complejos Prematuros Ventriculares/cirugíaAsunto(s)
Fascículo Atrioventricular/fisiopatología , Estimulación Cardíaca Artificial , Técnicas Electrofisiológicas Cardíacas , Taquicardia por Reentrada en el Nodo Atrioventricular/diagnóstico , Potenciales de Acción , Ablación por Catéter , Electrocardiografía , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Taquicardia por Reentrada en el Nodo Atrioventricular/fisiopatología , Taquicardia por Reentrada en el Nodo Atrioventricular/cirugíaRESUMEN
Bundle branch reentrant tachycardia (BBRT) is an uncommon form of ventricular tachycardia involving diseased bundle branches. Phase IV bundle branch block also accompanies severe His-Purkinje disease. We present an unusual case of BBRT in a patient who also manifests a unique self-perpetuating cycle of AV block and phase IV left bundle branch block following aortic valve surgery. BBRT was treated successfully by ablation of the right bundle.