Atrioventricular Nodal Reentrant Tachycardia with Advanced Infra-Hisian Atrioventricular Block

Abstract

We report a case of 78-year-old man admitted to the hospital due to palpitations and lightheadedness. On EKG advanced atrioventricular block with ventricular rate of 37 beats per minute was noted. On electrophysiology study a common type of atrioventricular nodal reentrant tachycardia was inducible with maintenance of advanced AV block. Radiofrequency ablation of slow pathway followed by placement of a permanent pacemaker resulted in elimination of tachycardia and resolution of symptoms.

A unique form of a brady‐tachy syndrome

“…The development of physiologic AV block during AVNRT (especially during its beginning or end) is a well‐recognized, albeit infrequent, phenomenon. However, to our knowledge, there are only two reported cases describing AVNRT in the presence of continuous pathologic AV block . In each of the previous reports, VA conduction was not present and the AVNRT could not be entrained by VOP.…”

“…However, to our knowledge, there are only two reported cases describing AVNRT in the presence of continuous pathologic AV block. 1,2 In each of the previous reports, VA conduction was not present and the AVNRT could not be entrained by VOP. This case serves as a reminder that VOP may still be useful in patients with supraventricular tachycardia and AV block when VA conduction F I G U R E 3 AA, atrial electrogram to atrial electrogram time interval; PCL, ventricular pacing cycle length; VOP, ventricular overdrive pacing.…”