title: Atrioventricular nodal re-entrant tachycardia with QRS voltage and cycle length alternation and aberrant conduction due to two distinct antegrade slow pathways.
abstract: QRS voltage and cycle length alternation can be seen during supraventricular re-entrant tachycardias, especially in atrioventricular (AV) re-entrant tachycardia. We present a case of a 20-year-old man, in which AV nodal re-entrant tachycardia (AVNRT) shows alternation of QRS voltage and cycle length, as well as right bundle branch block aberration due to a re-entrant circuit using two distinct, beat-to-beat alternating slow AV nodal pathways antegradely and a single fast pathway retrogradely. Although more than one antegrade slow pathway exists, creation of a single lesion at the right posterior atrial septum using the conventional right-sided approach successfully eliminated AVNRT.
authors.affiliation: Department of Cardiology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey. dramasyali@yahoo.com
authors.forename: Basri
authors.initials: B
authors.lastname: Amasyali
authors.forename: Sedat
authors.initials: S
authors.lastname: Kose
authors.forename: Turgay
authors.initials: T
authors.lastname: Celik
mesh_terms: D000328:Adult; D002037:Bundle-Branch Block / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery