title: [Role of a "bystander" concealed accessory pathway in the response to verapamil and flecainide treatment in a patient with nodal reentry tachycardia].
abstract: The possibility of multiple accessory atrioventricular pathways as that of multiple atrioventricular "nodal" pathways represents a relatively usual finding in patients suffering from supraventricular reciprocating tachycardias; the occurrence of both double atrioventricular nodal and concealed accessory pathways in the same patient, on the contrary, is far less common, and is usually an unsuspected condition prior to an electrophysiologic endocavitary study. The authors describe a patient suffering from paroxysmal tachycardias of both types, which have been clearly demonstrated by a transesophageal electrophysiological study. The report shows the different effects of two drugs, verapamil and flecainide, on these reciprocating circuits. Flecainide showed an immediate effectiveness in this condition, while verapamil, although very effective for the "nodal" reciprocating tachycardia, might worsen the accessory reentrant one, and cause a "jump" from the first to the second form.
authors.affiliation: Servizio di Cardiologia, Ospedale di Subiaco, Roma.
authors.forename: C
authors.initials: C
authors.lastname: Matteucci
authors.forename: G
authors.initials: G
authors.lastname: Busi
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D002648:Child; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005424:Flecainide / Q000627:therapeutic use*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D013614:Tachycardia, Paroxysmal / Q000188:drug therapy / Q000503:physiopathology*; D013615:Tachycardia, Sinoatrial Nodal Reentry / Q000503:physiopathology*; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000503:physiopathology*; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D000889:Anti-Arrhythmia Agents; D014700:Verapamil; D005424:Flecainide
vernacular_title: Ruolo di una via accessoria occulta "bystander" nella risposta al trattamento farmacologico con verapamil e con flecainide in un paziente affetto da tachicardia da rientro nodale.