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Europace Advance Access originally published online on January 10, 2006
Europace 2006 8(2):134-137; doi:10.1093/europace/euj033
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

ELECTROPHYSIOLOGY

Atrioventricular nodal re-entrant tachycardia with QRS voltage and cycle length alternation and aberrant conduction due to two distinct antegrade slow pathways

Basri Amasyali*, Sedat Kose and Turgay Çelik

Department of Cardiology Gulhane Military Medical Academy, 06018 Etlik, Ankara Turkey

QRS voltage and cycle length alternation can be seen during supraventricular re-entrant tachycardias, especially in atrioventricular (AV) re-entrant tachycardia. We present a case of a 20-year-old man, in which AV nodal re-entrant tachycardia (AVNRT) shows alternation of QRS voltage and cycle length, as well as right bundle branch block aberration due to a re-entrant circuit using two distinct, beat-to-beat alternating slow AV nodal pathways antegradely and a single fast pathway retrogradely. Although more than one antegrade slow pathway exists, creation of a single lesion at the right posterior atrial septum using the conventional right-sided approach successfully eliminated AVNRT.

Key Words: Atrioventricular nodal re-entrant tachycardia, Cycle length alternation, QRS alternation, Right bundle branch block

Corresponding author. Tel: +90 312 304 2390; fax: +90 312 304 4250. E-mail address: dramasyali{at}yahoo.com


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