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Itoh T, Nishizaki K, Kimura M, Tomita H. Impact of Multilevel Atrioventricular Block on Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia Alongside Typical Atrial Flutter. JACC Clin Electrophysiol 2023:S2405-500X(23)00840-X. [PMID: 38206262 DOI: 10.1016/j.jacep.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/10/2023] [Accepted: 11/08/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Taihei Itoh
- Department of Advanced Management of Cardiac Arrhythmia, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Kimitaka Nishizaki
- Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masaomi Kimura
- Department of Advanced Management of Cardiac Arrhythmia, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hirofumi Tomita
- Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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2
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Asada S, Nakagawa K, Nishii N, Morita H, Nakamura K. A variability of the QRS morphology during wide QRS tachycardia. Pacing Clin Electrophysiol 2023; 46:1568-1571. [PMID: 37932889 DOI: 10.1111/pace.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Saori Asada
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
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3
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Efe TH, Merovci I, Oksuz F, Eris E, Kara M, Burunkaya DK, Ozcan Cetin EH, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. The Roles of Pre-P-wave Versus Peri-P-wave Fractionated Electrograms for Atrial Substrate Beyond Entrainment Response. J Innov Card Rhythm Manag 2023; 14:5465-5470. [PMID: 37388421 PMCID: PMC10306251 DOI: 10.19102/icrm.2023.14065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/17/2022] [Indexed: 07/01/2023] Open
Abstract
Atrial tachycardia (AT) with alternating cycle lengths is sparsely reported, and, hence, the ideal mapping strategy has not been firmly established. Beyond the entrainment during tachycardia, some fragmentation characteristics might also give important clues for its possible participation in the macro-re-entrant circuit. We discuss a patient with prior atrial septal defect surgical closures who presented with dual macro-re-entrant ATs related to a fragmented area on the right atrial free wall (240 ms) and the cavotricuspid isthmus (260 ms), respectively. After ablation of the fastest AT on the lateral right atrial free wall, the cycle of the first AT changed to the second AT that was interrupted on cavotricuspid isthmus, proving the dual tachycardia mechanism. This case report addresses the utilization of electroanatomic mapping information as well as fractionated electrogram timing with respect to the surface P-wave as guides for ablation location.
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Affiliation(s)
- Tolga Han Efe
- Department of Cardiology, University of Health Sciences, Dıs¸kapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Idriz Merovci
- Department of Cardiology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Fatih Oksuz
- Department of Cardiology, University of Health Sciences, Ankara Hospital, Ankara, Turkey
| | - Erdeniz Eris
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Meryem Kara
- Department of Cardiology, University of Health Sciences, Dıs¸kapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | | | - Elif Hande Ozcan Cetin
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Korkmaz
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, I˙stanbul Medipol University, Istanbul, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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4
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Korkmaz A, Özeke Ö, Cay S, Ozcan F, Kara M, Ozcan Cetin EH, Beton N, Aksoy A, Saribas H, Merovci I, Demirhan C, Aras D, Topaloglu S. Atrial Tachycardia with Cycle Length Alternans. J Innov Card Rhythm Manag 2023; 14:5436-5441. [PMID: 37216083 PMCID: PMC10193878 DOI: 10.19102/icrm.2023.14052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/26/2022] [Indexed: 05/24/2023] Open
Abstract
Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. The underlying mechanism for stable beat-to-beat cycle length variability (alternans) in atrial tachycardia has been sparsely reported.
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Affiliation(s)
- Ahmet Korkmaz
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Özcan Özeke
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Meryem Kara
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Nur Beton
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Atik Aksoy
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Halenur Saribas
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Idriz Merovci
- Department of Cardiology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Can Demirhan
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, Istanbul Medipol University, Istanbul, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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5
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Aslan AO, Merovci I, Tunçez A, Oksuz F, Al EA, Kara M, Cetin EHO, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. Widening of the QRS complex during the wide complex tachycardia: What is the mechanism? J Cardiovasc Electrophysiol 2022; 33:1605-1608. [PMID: 35671328 DOI: 10.1111/jce.15567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/27/2022]
Abstract
Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ahmet Oguz Aslan
- Health Sciences University, Ahi Evren Thoracic, and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Idriz Merovci
- University Clinical Center of Kosovo, Department of Cardiology, Prishtina, Kosovo
| | | | - Fatih Oksuz
- Health Sciences University, Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Ertan Andac Al
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Meryem Kara
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ahmet Korkmaz
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ozcan Ozeke
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Serkan Cay
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Firat Ozcan
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- İstanbul Medipol University, Department of Cardiology, İstanbul, Turkey
| | - Serkan Topaloglu
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
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Aslan AO, Merovci I, Tunçez A, Oksuz F, Kara M, Cetin EHO, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. Simultaneous narrow and wide QRS complex tachycardia: Misdiagnosis or Missed diagnosis? J Cardiovasc Electrophysiol 2022; 33:1599-1604. [PMID: 35612357 DOI: 10.1111/jce.15560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/17/2022] [Accepted: 05/22/2022] [Indexed: 11/30/2022]
Abstract
Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. Regardless of the mechanism, this case illustrates the importance of assessing the response to multiple different pacing maneuvers in determining the mechanism of narrow and wide QRS complex tachycardias, rather than relying upon a single maneuver, even one that is believed to be diagnostic. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ahmet Oguz Aslan
- Health Sciences University, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Idriz Merovci
- University Clinical Center of Kosovo, Department of Cardiology, Prishtina, Kosovo, Turkey
| | | | - Fatih Oksuz
- Health Sciences University, Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Meryem Kara
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ahmet Korkmaz
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ozcan Ozeke
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Serkan Cay
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Firat Ozcan
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- İstanbul Medipol University, Department of Cardiology, İstanbul, Turkey
| | - Serkan Topaloglu
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
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Yasumoto K, Egami Y, Ukita K, Kawamura A, Nakamura H, Matsuhiro Y, Tsuda M, Okamoto N, Tanaka A, Matsunaga-Lee Y, Yano M, Shutta R, Nishino M, Tanouchi J. A narrow QRS tachycardia with varying right atrial activation sequence: What is the mechanism? J Cardiovasc Electrophysiol 2021; 32:871-873. [PMID: 33428306 DOI: 10.1111/jce.14875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 12/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Koji Yasumoto
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Yasuyuki Egami
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Kohei Ukita
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Akito Kawamura
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | | | - Masaki Tsuda
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Akihiro Tanaka
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | | | - Masamichi Yano
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Ryu Shutta
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Masami Nishino
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
| | - Jun Tanouchi
- Division of Cardiology, Osaka Rosai Hospital, Sakai, Japan
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8
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Di C, Gao P, Wang Q, Wu Y, Lin W. Atrial cycle length alternans during typical atrial flutter: What is the mechanism? J Cardiovasc Electrophysiol 2019; 30:2134-2136. [PMID: 31432543 DOI: 10.1111/jce.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Chengye Di
- Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Peng Gao
- Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Qun Wang
- Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Yanxi Wu
- Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
| | - Wenhua Lin
- Cardiac Electrophysiology Unit, First Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin, China
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Mohanan Nair KK, Namboodiri N, Kevadiya H, Valaparambil A. Interesting case of dual tachycardia in a patient with surgical closure of atrial septal defect. J Cardiovasc Electrophysiol 2018; 30:265-266. [PMID: 30288854 DOI: 10.1111/jce.13769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 09/26/2018] [Accepted: 10/03/2018] [Indexed: 11/28/2022]
Abstract
A 34-year-old gentleman, who had undergone pericardial patch closure of ostium secundum atrial septal defect (ASD) at 8 years of age, was evaluated for shortness of breath. Electrocardiogram revealed typical atrial flutter with varying atrioventricular conduction. Echocardiogram showed no residual ASD or pulmonary hypertension and good biventricular function. He was taken for an electrophysiological study with the intention of radiofrequency ablation of the typical flutter.
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Affiliation(s)
- Krishna Kumar Mohanan Nair
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Narayanan Namboodiri
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Hiren Kevadiya
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Ajitkumar Valaparambil
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
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Nakashima T, Kubota T, Takasugi N, Kawasaki M, Nishigaki K, Minatoguchi S. Simultaneous independent double tachycardias: What is the mechanism? J Cardiovasc Electrophysiol 2018; 29:800-802. [PMID: 29436062 DOI: 10.1111/jce.13463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/06/2018] [Accepted: 02/09/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Takashi Nakashima
- Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Tomoki Kubota
- Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Nobuhiro Takasugi
- Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Masanori Kawasaki
- Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Kazuhiko Nishigaki
- Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Shinya Minatoguchi
- Department of Cardiology, Graduate School of Medicine, Gifu University, Gifu, Japan
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Nair KKM, Namboodiri N, Banavalikar B, Inamdar S, Valaparambil A, Thajudeen A, Tharakan J. Narrow QRS Tachycardia with Spontaneous Switch. What Is the Mechanism? Pacing Clin Electrophysiol 2016; 39:768-70. [PMID: 27120715 DOI: 10.1111/pace.12874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 04/07/2016] [Accepted: 04/15/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Krishna Kumar Mohanan Nair
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Narayanan Namboodiri
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Bharatraj Banavalikar
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Sonali Inamdar
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Ajitkumar Valaparambil
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Anees Thajudeen
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Jaganmohan Tharakan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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Uetake S, Maruyama M, Yamamoto T, Hata N, Seino Y, Shimizu W. Conversion from Two Types of Wide QRS Complex Tachycardia to Narrow QRS Complex Tachycardia: What Are the Mechanisms? J Cardiovasc Electrophysiol 2015; 27:129-30. [PMID: 26100346 DOI: 10.1111/jce.12747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 06/17/2015] [Accepted: 06/19/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Shunsuke Uetake
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Mitsunori Maruyama
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Teppei Yamamoto
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Noritake Hata
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yoshihiko Seino
- Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
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13
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Miyazaki S, Uchiyama T, Iesaka Y. An irregular supraventricular tachycardia: what is the mechanism? J Cardiovasc Electrophysiol 2014; 26:231-2. [PMID: 25213766 DOI: 10.1111/jce.12541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 11/28/2022]
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14
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Haghjoo M, Arya A, Dehghani M, Emkanjoo Z, Fazelifar A, Heidari A, Sadr-Ameli M. Coexistence of atrioventricular nodal reentrant tachycardia and idiopathic left ventricular outflow-tract tachycardia. Indian Pacing Electrophysiol J 2005; 5:149-54. [PMID: 16943955 PMCID: PMC1502080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Double tachycardia is a relatively rare condition. We describe a 21 year old woman with history of frequent palpitations. In one of these episodes, she had wide complex tachycardia with right bundle branch and inferior axis morphology. A typical atrioventricular nodal tachycardia was induced during electrophysiologic study, aimed at induction of clinically documented tachycardia. Initially no ventricular tachycardia was inducible. After successful ablation of slow pathway, a wide complex tachycardia was induced by programmed stimulation from right ventricular outflow tract. Mapping localized the focus of tachycardia in left ventricular outflow tract and successfully ablated via retrograde aortic approach. During 7 month's follow-up, she has been symptom free with no recurrence. This work describes successful ablation of rare combination of typical atrioventricular nodal tachycardia and left ventricular outflow tract tachycardia in the same patient during one session.
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Affiliation(s)
- Majid Haghjoo
- Department of Pacemaker and Electrophysiology, Shahid Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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15
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Ozin B, Pirat B, Muderrisoglu H. Interesting electrophysiological findings in a patient with coincidental right ventricular outflow tract and atrioventricular nodal reentrant tachycardia. Indian Pacing Electrophysiol J 2004; 4:93-6. [PMID: 16943976 PMCID: PMC1501069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Tachycardia induced tachycardias are not common in clinical practice, and it is believed that most cases of double tachycardia are coincidental. The existence of two different tachycardias in the same patient almost always poses problems in the electrophysiology laboratory. However, in rare instances, the emergence of a second tachycardia can actually provide invaluable information about the first one. In this report, we describe a 30-year-old woman who presented with palpitations. Electrophysiological study revealed that atrial programmed stimulation at baseline induced right ventricular outflow tract (RVOT) tachycardia and supraventricular tachycardia. The study also showed that each of the tachycardias was able to induce the other. A short run of RVOT tachycardia during supraventricular tachycardia was able to entrain the latter. This finding provided important information about the nature of the supraventricular tachycardia, which proved to be atrioventricular nodal reentrant tachycardia. Both of these tachycardias were successfully ablated, and the patient's palpitations disappeared.
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Affiliation(s)
- Bulent Ozin
- Baskent University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
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