Atrioventricular nodal reentrant tachycardia associated with idiopathic ventricular tachycardia: clinical and electrophysiologic characteristics.
BACKGROUND
Case reports have described the coexistence of ventricular tachycardia (VT) and supraventricular tachycardia in the same patient. This study examines the frequency of dual atrioventricular nodal (AVN) physiology, AVN echo beats, and atrioventricular nodal reentrant tachycardia (AVNRT) in patients with VT.


METHODS
Programmed atrial and ventricular stimulation was performed in 132 consecutive patients referred for electrophysiologic study of symptomatic VT. Of the 132, 99 patients had structural heart disease, and 33 patients had idiopathic ventricular tachycardia (IVT).


RESULTS
Among the 33 patients with IVT, 23 had dual AVN physiology. Compared with patients with structural heart disease undergoing VT ablation, dual AVN pathways (70% vs 27%, P < .0001), dual AVN pathways with echo beats (24% vs 8%, P = 0.03), and AVNRT (21% vs 1%, P = .0002) were more common in patients with IVT.


CONCLUSIONS
Dual AVN physiology and AVNRT appear to be associated with IVT. This finding suggests that patients with IVT should undergo a complete electrophysiologic evaluation, and the diagnosis of coexistent AVNRT should be considered in this population.
Wylie
John V
JV
Cardiovascular Division, Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Milliez
Paul
P
Germano
Joseph J
JJ
Richardson
Allison
A
Ngwu
Ogundu
O
Zimetbaum
Peter J
PJ
Papageorgiou
Panos
P
Josephson
Mark E
ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000453:epidemiology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology