Atrioventricular nodal supraventricular tachycardia with 2:1 block above the bundle of His.
A patient with narrow complex supraventricular tachycardia underwent electrophysiological study at which time a tachycardia was initiated which had 2:1 AV conduction, with block occurring above the His bundle. The modes of tachycardia initiation, as well as the responses to atrial and ventricular premature depolarizations during tachycardia, made a diagnosis of atrioventricular nodal reentry as the tachycardia mechanism. The unusual finding of 2:1 supra-His block suggests the presence of tissue situated between the tachycardia circuit and His bundle, and effectively excludes the possibility of a His-atrial bypass tract as the retrograde limb of the tachycardia circuit.
Schmitt
C
C
Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, Philadelphia 19104.
Miller
J M
JM
Josephson
M E
ME
D000328:Adult; D002036:Bundle of His / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology*; D013617:Tachycardia, Supraventricular / Q000503:physiopathology*