Radiofrequency catheter ablation of coexistent idiopathic left ventricular tachycardia and atrioventricular nodal reentrant tachycardia.
A healthy 15-year-old male patient presented with a 6-month history of recurrent attacks of palpitations. On multiple emergency room visits, a sustained wide QRS complex tachycardia with a right bundle branch block and northwest axis deviation was documented. The tachycardia was not terminated by intravenous adenosine, but was suppressed with intravenous verapamil. There was no evidence of structural heart disease, myocarditis, long QT syndrome, or electrolyte imbalance after a series of standard examinations. Idiopathic left ventricular tachycardia (ILVT) was suspected. Electrophysiologic studies revealed 2 inducible tachycardias, which were shown to represent atrioventricular nodal reentrant tachycardia (AVNRT) and ILVT. Transformation from AVNRT to ILVT occurred spontaneously following atrial pacing. Successful ablation of ILVT and the slow atrioventricular nodal pathway resulted in cure of the double tachycardia.
Weng
Ken-Pen
KP
Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC. kingpw@yam.com
Chiou
Chuen-Wang
CW
Kung
Ming-Ho
MH
Lin
Chu-Chuan
CC
Hsieh
Kai-Sheng
KS
D000293:Adolescent; D017115:Catheter Ablation; D006801:Humans; D008297:Male; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000601:surgery*