[Supraventricular tachycardia due to retrograde decremental conduction over accessory pathways].
OBJECTIVE
To discuss the clinical and the electrophysiologic findings, the differential diagnosis and the behaviour of concealed retrograde long conduction time accessory pathways.


METHODS
Seventeen patients were submitted to electrophysiologic study using programmed electrical stimulation of the heart to assess the electrophysiologic properties of the accessory pathway.


RESULTS
In all 17 studied patients, it was possible to advance the next atrial activation by giving a ventricular premature beat during the refractoriness of the His bundle. Of 17 patients, 7 developed signs and symptoms of heart failure (tachycardia-induced cardiomyopathy) due to the presence of incessant tachycardia. Eight patients were cured surgically and 1 underwent DC catheter ablation of the AV node. Six patients were successfully treated with antiarrhythmic drugs, one die of cancer and one still presents incessant tachycardia.


CONCLUSIONS
The electrophysiologic study is essential for the differential diagnosis of the supraventricular tachycardias with a R-P' interval longer than P'-R interval where the incidence of tachycardiomyopathy is high in this group of patients. Surgery provides definitive cure of those patients leading to the regression of the signs and symptoms of heart failure.
Cruz Filho
F E
FE
Hospital Acadêmico de Maastricht, Universidade de Limburg, Holanda.
Wellens
H J
HJ
Peres
A
A
Seixas
T
T
Brugada
P
P
Smeets
J L
JL
D000293:Adolescent; D000328:Adult; D001283:Atrioventricular Node / Q000002:abnormalities* / Q000503:physiopathology; D006328:Cardiac Catheterization; D002648:Child; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods; D004594:Electrophysiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000209:etiology*
Taquicardia supraventricular por vias accessórias de condução retrógrada decremental.