Narrow Complex Tachycardia: What is the Mechanism?

Marwan M Refaat; Melvin Scheinman; Nitish Badhwar

doi:10.1016/j.ccep.2015.10.006

Narrow Complex Tachycardia: What is the Mechanism?

Card Electrophysiol Clin. 2016 Mar;8(1):67-9. doi: 10.1016/j.ccep.2015.10.006. Epub 2016 Jan 13.

Authors

Marwan M Refaat¹, Melvin Scheinman², Nitish Badhwar²

Affiliations

¹ Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Faculty of Medicine and Medical Center, American University of Beirut, PO Box 11-0236, Riad El-Solh, Beirut 1107 2020, Lebanon. Electronic address: mr48@aub.edu.lb.
² Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, 500 Parnassus Avenue, San Francisco, CA 94143, USA.

PMID: 26920172
DOI: 10.1016/j.ccep.2015.10.006

Abstract

This article presents a diagnostic dilemma in which atrioventricular nodal reentrant tachycardia (AVNRT) and junctional tachycardia (JT) were differentiated based on tachycardia initiation with atrial extrastimulus as well as on the response to progressive decremental atrial extrastimuli. The progressive increase in A2H2' and H2H2' in response to atrial extrastimuli favors reentry as the mechanism of the tachycardia. This is a novel mechanistic differentiation of AVNRT from focal JT.

Keywords: Atrioventricular nodal reentrant tachycardia; Catheter ablation; Junctional tachycardia.

Publication types

Case Reports
Review

MeSH terms

Catheter Ablation
Diagnosis, Differential
Electrocardiography
Humans
Male
Middle Aged
Tachycardia, Atrioventricular Nodal Reentry* / diagnosis
Tachycardia, Atrioventricular Nodal Reentry* / physiopathology
Tachycardia, Atrioventricular Nodal Reentry* / therapy
Tachycardia, Ectopic Junctional* / diagnosis
Tachycardia, Ectopic Junctional* / physiopathology
Tachycardia, Ectopic Junctional* / therapy
Tachycardia, Supraventricular / physiopathology