Dual antegrade response tachycardia induced cardiomyopathy.
We report a rare case of tachycardia induced cardiomyopathy resulting from nearly incessant dual antegrade response tachycardia. Criteria necessary for sustaining dual antegrade responses are discussed, including: (1) sufficient antegrade dissociation of the AV node; (2) absence of retrograde conduction over each AV nodal pathway following antegrade conduction over its counterpart; (3) difference between fast and slow pathway conduction times exceeding His-Purkinje refractoriness; and (4) critical timing of sinus impulses relative to preceding AV nodal conduction. Both the arrhythmia and cardiomyopathy were successfully treated by slow pathway ablation.
Gaba
Deepak
D
Department of Medicine, Division of Cardiovascular Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Pavri
Behzad B
BB
Greenspon
Arnold J
AJ
Ho
Reginald T
RT
D000328:Adult; D009202:Cardiomyopathies / Q000209:etiology* / Q000601:surgery; D017115:Catheter Ablation; D004562:Electrocardiography; D006327:Heart Block / Q000503:physiopathology; D006801:Humans; D008297:Male; D013610:Tachycardia / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery