Spontaneous automaticity of an atriofascicular accessory pathway.
In a 12-year-old girl with history of recurrent palpitation, an ambulatory 24 h Holter electrocardiogram showed a wide QRS complex rhythm with atrioventricular dissociation. During an electrophysiology study, an atriofascicular pathway was diagnosed with an inducible antidromic atrioventricular re-entrant tachycardia. At slower heart rates, the patient had a wide QRS complex escape rhythm similar to the tachycardia and the pre-excited QRS complex morphology. This indicates the presence of pacemaker-like cells in the atriofascicular accessory pathway giving rise to the wide QRS complex escape rhythm at a slower heart rate.
Dora
Santosh Kumar
SK
Division of Cardiology Department of Medicine, Cedars-Sinai Medical Center, Los-Angeles, CA 90048, USA. kskdora@hotmail.com
Tharakan
Jaganmohan A
JA
Valaparambil
Ajithkumar
A
Namboodiri
Narayanan
N
Nair
Krishnakumar
K
Peter
Thomas
T
D002037:Bundle-Branch Block / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D002648:Child; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery