scholarly journals Case Report: Wide-to-Narrow QRS Tachycardia in a 3-Month-Old Infant

2021 ◽  
Vol 8 ◽  
Author(s):  
Liang Zhao ◽  
Song Yan ◽  
Tao Wang ◽  
Yimin Hua ◽  
Kaiyu Zhou
Keyword(s):  
Case Report ◽  
Accessory Pathway ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Reentrant Tachycardia ◽  
Bundle Branch Block ◽  
Atrioventricular Reentrant Tachycardia ◽  
Non Invasive ◽  
Narrow Qrs ◽  
Electrophysiological Examination ◽  
Concealed Accessory Pathway

Introduction: It is rare to find that wide QRS tachycardia automatically changes to narrow QRS tachycardia, and it is more difficult to clarify the mechanism.Case Report: A 3-month-old infant with recurrent paroxysmal supraventricular tachycardia underwent transesophageal cardiac electrophysiological examination. The wide QRS tachycardia was induced by atrial RS2 stimulation, and it soon changed to narrow QRS tachycardia automatically. By the accurate measurement of esophageal lead, it was found that the electrocardiogram changes completely conform to Coumel law. The mechanism of wide and narrow QRS tachycardia was orthodromic atrioventricular reentrant tachycardia with or without ipsilateral functional bundle branch block, and the accessory pathway was defined as the left free wall-concealed accessory pathway.Conclusion: Transesophageal cardiac electrophysiological examination can reveal some special electrophysiological phenomena, and its non-invasive nature is especially suitable for infants.

scholarly journals Discordant Pacing Manoeuvers and a Narrow QRS Tachycardia – What is the Tachycardia Mechanism?

2015 ◽  
Vol 01 (01) ◽  
pp. 32 ◽  
Author(s):  
Hussam Ali ◽  
Pierpaolo Lupo ◽  
Sara Foresti ◽  
Guido De Ambroggi ◽  
Gianluca Epicoco ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Electrophysiological Study ◽  
Correct Diagnosis ◽  
Accessory Pathway ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Ventricular Pacing ◽  
Reentrant Tachycardia ◽  
Narrow Qrs ◽  
Atrial Activation

A 24-year-old female underwent an electrophysiological study because of recurrent episodes of drug-refractory, paroxysmal supraventricular tachycardia. During adrenergic stress, a narrow QRS tachycardia with eccentric atrial activation was reproducibly inducible. The response to premature ventricular extrastimulation during tachycardia suggested the presence of a slowly conducting accessory pathway. However, a comprehensive appraisal of the electrophysiological study delineated the tachycardia substrate as an atypical atrioventricular nodal reentrant tachycardia in the presence of a bystander nodofascicular pathway. Careful analysing of the basal pacing manoeuvers during sinus rhythm (para-Hisian and differential ventricular pacing) was crucial to establish the correct diagnosis and to avoid unnecessary left-side access to ablate this tachycardia.

PP-291 UNUSUAL CONCEALED ACCESSORY PATHWAY ABLATION: CASE REPORT

2013 ◽  
Vol 163 (3) ◽  
pp. S198
Author(s):  
H. Sunman ◽  
K. Aytemir ◽  
Ş.G. Fatihoglu ◽  
U. Canpolat ◽  
N. Maharjan ◽  
...  
Keyword(s):  
Case Report ◽  
Accessory Pathway ◽  
Concealed Accessory Pathway

Supraventricular Tachycardia

2020 ◽  
Author(s):  
Laurence M. Epstein ◽  
Saurabh Kumar
Keyword(s):  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Tissue ◽  
Accessory Pathway ◽  
Maze Procedure ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Inappropriate Sinus Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Supraventricular Tachycardias

Supraventricular tachycardias (SVTs) comprise a group of usually benign arrhythmias that originate from cardiac tissue at or above the His bundle. SVTs include inappropriate sinus tachycardia, atrial tachycardias (ATs), atrial flutter (AFL), junctional tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT), and forms of accessory pathway–mediated reentrant tachycardias (atrioventricular reentrant tachycardia [AVRT]). Although mostly benign, symptoms can be debilitating, in the form of palpitations, shortness of breath, chest discomfort, dizziness, and/or syncope; rarely, SVTs can result in cardiomyopathy due to incessant arrhythmia. This review covers the epidemiology, diagnosis, management, and classification of SVTs.  This review contains 14 figures, 17 tables, and 61 references. Keywords: Supraventricular tachycardia, cardioversion, arrhythmia, atrial flutter, atrial fibrillation, Wolff-Parkinson-White syndrome, MAZE procedure, catheter ablation

Risk factors of recurrence and complication in radiofrequency catheter ablation of atrioventricular reentrant tachycardia in children and adolescents

2013 ◽  
Vol 23 (5) ◽  
pp. 682-691 ◽  
Author(s):  
Tien H. Chen ◽  
Ming-Lung Tsai ◽  
Po-Cheng Chang ◽  
Hung-Ta Wo ◽  
Chung-Chuan Chou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Catheter Ablation ◽  
Children And Adolescents ◽  
Radiofrequency Catheter Ablation ◽  
Congenital Heart ◽  
Accessory Pathway ◽  
Reentrant Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Accessory Pathways

AbstractBackgroundTo compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic atrioventricular reentrant tachycardia in children and adolescents.MethodsWe retrospectively reviewed the data of 213 consecutive patients with symptomatic atrioventricular reentrant tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age <12 years) and adolescents (12 ≤ age < 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups.ResultsThe position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children.ConclusionsThe findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of atrioventricular reentrant tachycardia in children and adolescents.

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