An atypical arrhythmia
نویسنده
چکیده
There is a narrow complex tachycardia with a rate of approximately 160 beats/min. The electrical axis is intermediate (almost vertical). In every supraventricular tachycardia the position of the P wave is critical for the diagnosis. Here the P wave seems to be present 120 ms before the QRS complex (i.e. long RP, short PR interval). The P-wave configuration is negative in leads II and III and positive in lead I (V1 and V2). Based on the position of the P wave the differential diagnosis includes atrial tachycardia, orthodromic AV re-entry (with a slowly conducting bypass track) and atypical atrioventricular nodal reentrant tachycardia (AVNRT, from atrium to ventricle via the fast pathway and from ventricle to atrium via the slow pathway). Close inspection of Fig. 1 reveals that the P wave is lacking in the 4th full RR interval calculated from the right (arrows). This excludes the first two possibilities and leaves atypical AVNRT as the most likely diagnosis.
منابع مشابه
Atypical development of resting respiratory sinus arrhythmia in children at high risk for depression.
Compromised respiratory sinus arrhythmia (RSA, i.e., low cardiac vagal control) frequently characterizes clinically depressed adults and also has been detected in infants of depressed mothers; however, its existence has not been established in older at-risk offspring. We investigated developmental patterns of RSA in a sample of 163 5- to 14-year-old children, who were either at high risk for de...
متن کاملIdentical atrio-His interval and A-A intervals during long RP tachycardia: what is the mechanism? Diagnosis: Atypical AVNRT.
متن کامل
Catheter Ablation of Atypical Atrioventricular Nodal Reentrant Tachycardia.
BACKGROUND Because of its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method has not been established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT. METHODS We studied 2079 patients with AVNRT subjected to slow pathway ab...
متن کاملCatheter ablation of atypical atrial flutter and atrial tachycardia within the coronary sinus after left atrial ablation for atrial fibrillation.
OBJECTIVES The goal of this study was to describe the prevalence and ablation of coronary sinus (CS) arrhythmias after left atrial ablation for atrial fibrillation (AF). BACKGROUND The CS has been implicated in a variety of supraventricular arrhythmias. METHODS Thirty-eight patients underwent mapping and ablation of atypical flutter that developed during (n = 5) or after (n = 33) ablation f...
متن کاملCoexistent Types of Atrioventricular Nodal Re-Entrant Tachycardia: Implications for the Tachycardia Circuit.
BACKGROUND There is evidence that atypical fast-slow and typical atrioventricular nodal re-entrant tachycardia (AVNRT) do not use the same limb for fast conduction, but no data exist on patients who have presented with both typical and atypical forms of this tachycardia. We compared conduction intervals during typical and atypical AVNRT that occurred in the same patient. METHODS AND RESULTS I...
متن کاملCardiac arrhythmia due to ledipasvir/sofosbuvir Iranian counterpart, commercially named as Ledibiox: A case report
Sofosbuvir is an antiviral drug that entirely revolutionized the treatment of hepatitis C. This drug has an Iranian commercial brand, which is known as Ledibiox. Several adverse events have been reported with this drug, including syncope, pancolitis, and exacerbated pulmonary arterial hypertension; however, arrhythmia rarely has been described through the literature. Here, we report a 40-year-o...
متن کامل