[A long RP tachycardia - an electrophysiological puzzle].
A case of a 30-year-old male with paroxysmal long RP tachycardia is presented. During electrophysiological study the clinical arrhythmia (atypical atrioventricular nodal reentrant tachycardia - AVNRT) was misdiagnosed as ectopic left atrial tachycardia due to ventricle-atrium-atrium-ventricle (VAAV) response after entrainment, eccentric atrial activation sequence and easiness in achieving atrio-ventricular dissociation with ventricular pacing during the tachycardia. Reassessment of the VAAV response lead to recognition of pseudo-VAAV response often seen in atypical, fast-slow AVNRT. Subsequent ablation of the slow pathway at standard site in the triangle of Koch was successful in eliminating the tachycardia.
Jastrzebski
Marek
M
I Klinika Kardiologii i Nadciśnienia Tetniczego, Szpital Uniwersytecki, ul. Kopernika 17, 31-501 Kraków, Poland. mcjastrz@cyf-kr.edu.pl
D000328:Adult; D004562:Electrocardiography; D006801:Humans; D008297:Male; D013617:Tachycardia, Supraventricular / Q000175:diagnosis*