Permanent form of junctional reciprocating tachycardia involving an atrio-hisian accessory pathway: electrophysiologic and histologic correlations.
We present clinical, electrophysiologic and morphologic correlations of a patient with a permanent form of junctional reciprocating tachycardia, who died from a lung tumor. At electrophysiologic study, the tachycardia circuit was suspected to involve an atrio-Hisian accessory pathway antegradely and the AV node retrogradely; a ventriculo-atrial accessory pathway was excluded. Pathologic examination revealed a right-sided atrio-Hisian accessory pathway and an area of abnormal dispersion in the distal His bundle fibers. This case is consistently different from another previously reported case in which a concealed, serpiginous, septal atrioventricular accessory pathway was demonstrated by anatomic examination. Thus, different substrates seem to be responsible for the permanent form of junctional reciprocating tachycardia.
D000368:Aged; D002036:Bundle of His / Q000473:pathology / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D008991:Monitoring, Physiologic; D013613:Tachycardia, Ectopic Junctional / Q000473:pathology / Q000503:physiopathology*; D013617:Tachycardia, Supraventricular / Q000503:physiopathology*