title: Persistent Atrial Fibrillation And Atrial Flutter Complicated By Tachycardiomyopathy Because Of Intermittent Conduction Through Accessory Pathway.
abstract: The term tachycardiomyopathy refers to a specific form of tachycardia-related cardiomyopathy caused by supraventricular or ventricular tachyarrhytmias that are both associated with ventricular rates higher than 120 bpm. The arrhythmias which are most frequently associated with these forms of heart disease are atrial fibrillation and atrial flutter, particularly found in the elderly population. The most frequent clinical manifestation is heart failure. In this case we are reporting a clinical case of a patient that came to our attention because of an episode of heart failure associated with atrial fibrillation and atrial flutter. The patient had also prolonged and repetitive strips of rapid conduction with wide QRS morphology. We don't know if the cause is pre excitation or ectopia. We showed that those strips of tachycardia with wide QRS, particularly when they were associated with atrial flutter, were so fast and consistent to determine the left ventricular contractile dysfunction; we showed also that those strips of wide complex tachycardia were caused by pre-excitation through an accessory right posteroseptal pathway and supported by the reentry circuit of common atrial flutter. The block of conduction through the accessory pathway and the elimination of atrial arrhythmia allowed the regression of left ventricular contractile dysfunction. We believe that this case is interesting because it shows that there is a strict continuity between sophisticated electrophysiological mechanisms and clinical manifestation.
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Valeri
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Coppolino
authors.affiliation: Department of Cardiology Electrophysiology Lab, ASO S. Croce e Carle Hospital, Cuneo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rossetti
authors.affiliation: Department of Cardiology Electrophysiology Lab, ASO S. Croce e Carle Hospital, Cuneo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vado
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Amoroso
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bricco
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Battisti
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: L
authors.initials: L
authors.lastname: Correndo
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: S
authors.initials: S
authors.lastname: Dogliani
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Magliarditi
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: D
authors.initials: D
authors.lastname: Pancaldo
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: M De
authors.initials: M
authors.lastname: Benedictis
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bassignana
authors.affiliation: Department of Cardiology, ASL CN1 SS. Annunziata Hospital, Savigliano (CN), Italy.
authors.forename: B
authors.initials: B
authors.lastname: Doronzo
keywords: Accesory Pathway; Atrial Fibrillation; Tachycardiomyopathy