Narrow Irregular QRS Tachycardia with AV Dissociation: What Is the Mechanism?

Congenitally corrected transposition of the great arteries (CCTGA) is rare form of congenital heart diseases. It may be present with or without associated anomalies. Patients with CCTGA are usually diagnosed at early stages of life due to associated anomalies, but they may even remain asymptomatic till later decades of their life. We report a case of a 42-year-old man who presented at neurosurgery department with dizziness, seizures, and loss of consciousness, in whom isolated CCTGA was discovered incidentally. Further investigation depicted right ventricular hypertrophy, mild valvular regurgitation, mildly dilated pulmonary artery, low heart rate with AV dissociation, and third-degree heart block. These indicated for implantation of permanent pacemaker into the patient. The implantation of VVI mode pacemaker was uneventful and the patient is being followed up in the past eight months in favorable condition.

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What Kind of AV Dissociation?

Hospital Practice ◽

10.1080/21548331.1992.11705380 ◽

1992 ◽

Vol 27 (3) ◽

pp. 60-62

Author(s):

E. William Hancock

Keyword(s):

Av Dissociation

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Possible AV Dissociation After Cardioversion

Hospital Practice ◽

10.1080/21548331.2001.11444140 ◽

2001 ◽

Vol 36 (9) ◽

pp. 19-20

Author(s):

E. William Hancock

Keyword(s):

Av Dissociation

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GW29-e1855 A special narrow QRS tachycardia with AV dissociation: dual accessary pathways with one of only retrograde bypass associated with orthodromic atrioventricular reciprocating tachycardia

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2018.08.658 ◽

2018 ◽

Vol 72 (16) ◽

pp. C141

Author(s):

Chao Zhu ◽

Kaizheng Gong

Keyword(s):

Narrow Qrs ◽

Atrioventricular Reciprocating Tachycardia ◽

Av Dissociation

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P968 Subcostal M-mode echocardiography of tricuspid annular motion helps recogntion of heart arrhythmias

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.600 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

N Drinkovic ◽

N Drinkovic Jr

Keyword(s):

Atrial Fibrillation ◽

Right Atrium ◽

Ventricular Arrhythmias ◽

Mechanical Efficiency ◽

Atrial Pacing ◽

Supraventricular Arrhythmias ◽

Characteristic Appearance ◽

Atrial Contraction ◽

Heart Arrhythmias ◽

Av Dissociation

Abstract Recognition of supraventricular arrhythmias and differention between supraventricular and ventricular rhythm abnormalities in ECG can sometimes be difficult due to indiscernible P wave. 1D echocardiography of tricuspid annular motion can quickly and reliably detect atrial contraction (Picture 1, figure 1a.) which has a characteristic appearance for majority of supraventricular arrhythmias. Since subcostal approach is almost always reliable, it allows simple and rapid recognition and differentiation between supraventricular arrhythmias, e.g. atrial fibrillation (Picture 1, figure 1b.) from atrial flutter and nodal rhythm. Detection of atrial contractions enables recognition of AV dissociation in ECG, which helps in differentiation between supraventricular and ventricular arrhythmias. This technique is also useful in checking the function and mechanical efficiency of atrial pacing. Figure 1a. Atrial contraction / sinus rhythm RA = right atrium A = atrial contraction Figure 1b. Atrial fibrillation RA = right atrium a = fibrillary contractions Abstract P968 Figure. Picture 1

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Apparent AV Dissociation upon Induction of a Narrow Complex Tachycardia. What Is the Mechanism?

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.2009.02656.x ◽

2010 ◽

Vol 33 (4) ◽

pp. 482-485

Author(s):

OSCAR CANO ◽

JOAQUÍN OSCA ◽

MARÍA-JOSÉ SANCHO-TELLO ◽

JOSÉ OLAGÜE

Keyword(s):

Av Dissociation ◽

Narrow Complex Tachycardia

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Atrioventricular Dissociation after Electroconvulsive Therapy

Cardiology Research and Practice ◽

10.4061/2011/746373 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4

Author(s):

Siegfried William Yu ◽

Srikanth Vallurupalli ◽

Jennifer Arnoldi ◽

Richard Holloway

Keyword(s):

Psychiatric Disorders ◽

Electroconvulsive Therapy ◽

Pacemaker Implantation ◽

Medical Complications ◽

Device Therapy ◽

Cardiac Effects ◽

Atrioventricular Dissociation ◽

Av Dissociation

Electroconvulsive therapy (ECT) is increasingly used as a treatment for psychiatric disorders. Cardiac effects are the principal cause of medical complications in these patients. We report a case of atrioventricular (AV) dissociation that occurred after ECT that was treated with pacemaker implantation. The mechanisms contributing to the onset of AV dissociation in this patient, and the management and rationale for device therapy, in light of the most recent guidelines, are reviewed.

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