Nonreentrant atrioventricular nodal tachycardia due to triple nodal pathways manifested by radiofrequency ablation at coronary sinus ostium

Yokoshiki, Hisashi; Sasaki, Koji; Shimokawa, Junichi; Sakurai, Minoru; Tsutsui, Hiroyuki

doi:10.1016/j.jelectrocard.2005.08.017

Cited by 13 publications

(5 citation statements)

References 11 publications

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“…Of note, the third P wave conducts with a shorter PR interval than the preceding slow pathway PR interval. While others attributed such a conduction pattern to the presence of an intermediate pathway, 2,3 it seems possible that during 1 : 2 conduction a reverse form of linking is present, and PR shortening implies relief of partial retrograde penetration in the slow pathway by an impulse from the fast pathway (Figs. 2 and 3).…”

Section: Commentarymentioning

confidence: 99%

Intermittent Impairment of Atrioventricular Conduction: What is the Mechanism?

Jastrzębski

2009

Cardiovasc electrophysiol

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Case PresentationThe electrocardiogram (ECG) presented in Figure 1 was obtained from a 62-year-old woman, with a 10-year history of heart palpitations and several syncopal and presyncopal episodes in the last few months, who was referred for electrophysiological study and pacemaker implantation. The echocardiogram was unremarkable apart from moderate tricuspid regurgitation. A nonarrhythmia ECG was also normal with a PR interval of 160 milliseconds. She presented with almost permanent irregular supraventricular tachyarrhythmia at 120-170 bpm, interspersed with frequent supraventricular ectopy (several thousand per 24 hour) and periods of pronounced paroxysmal first degree atrioventricular (AV) block with a PR of approximately 600 milliseconds (Fig. 1). Is it possible that a single mechanism underlies all of the observed ECG phenomena? Figure 1. A resting electrocardiogram typical for the current patient demonstrating supraventricular arrhythmia and an episode of pronounced first-degree AV block.

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Section: Commentarymentioning

confidence: 99%

Intermittent Impairment of Atrioventricular Conduction: What is the Mechanism?

Jastrzębski

2009

Cardiovasc electrophysiol

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“…[3][4][5] However, more than a dual antegrade conduction has only rarely been described. [6][7][8][9] A final consideration in any case of multiple-fire tachycardia is the rare possibility of a concealed nodoventricular pathway, which could result in nonsustained repetitive responses that could mimic multiple-pathways physiology. We did not perform programmed…”

Section: Ep Study Resultsmentioning

confidence: 99%

“…Numerous reports have also been published of multiple antegrade “jumps” (AH increment of >50 ms with 10 ms decrement in atrial coupling interval), which have been interpreted as being reflective of multiple AV nodal pathways 3–5 . However, more than a dual antegrade conduction has only rarely been described 6–9 …”

Section: Discussionmentioning

confidence: 99%

An unusual case of non‐reentrant atrioventricular nodal tachycardia

Raphael

Pavri

2022

Cardiovasc electrophysiol

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Introduction: Although uncommonly encountered, dual atrioventricular nodal nonreentrant tachycardia (DAVNNRT) is a well-described arrhythmia that can manifest in patients with dual atrioventricular nodal pathways physiology. This arrhythmia is characterized on electrocardiogram (ECG) by a single P wave followed by two conducted QRS complexes (so-called "double fire"), and on intracardiac electrograms by a single atrial electrogram followed by two separate His deflections and ventricular electrograms.Methods/Results: We report a rare case of "triple-fire" atrioventricular non-reentrant tachycardia in which a patient was found to have three distinct atrioventricular nodal pathways and multiple triple fire responses, both on surface ECG and intracardiac electrograms. Conclusion:Multiple pathways physiology and it's clinical ramifications are discussed.

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“…[3][4][5] However, more than a dual antegrade conduction has only rarely been described. [6][7][8][9] Our case demonstrates a most unusual presentation: "Triple-fire tachycardia" due to triple antegrade AV nodal pathways physiology, with the longest PR interval of 840 ms. This finding was repeatedly demonstrated throughout the study.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Non-Reentrant Atrioventricular Nodal Tachycardia

Raphael

Pavri

2022

Preprint

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Although uncommonly encountered, dual atrioventricular nodal non-reentrant tachycardia (DAVNNRT) is a well described arrhythmia that can manifest in patients with dual atrioventricular nodal pathways physiology. This arrhythmia is characterized on ECG by a single P wave followed by two conducted QRS complexes, and on intracardiac EGMs by a single atrial electrogram followed by two separate His deflections and ventricular electrograms. Our case demonstrates a rare case of “triple atrioventricular non-reentrant tachycardia” in which a patient was found to have 3 distinct AV nodal pathways and multiple “triple fire responses”, both on surface ECG and intracardiac electrograms.

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Nonreentrant atrioventricular nodal tachycardia due to triple nodal pathways manifested by radiofrequency ablation at coronary sinus ostium

Cited by 13 publications

References 11 publications

Intermittent Impairment of Atrioventricular Conduction: What is the Mechanism?

Intermittent Impairment of Atrioventricular Conduction: What is the Mechanism?

An unusual case of non‐reentrant atrioventricular nodal tachycardia

An Unusual Case of Non-Reentrant Atrioventricular Nodal Tachycardia

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