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Europace Advance Access originally published online on October 3, 2008
Europace 2008 10(12):1445-1446; doi:10.1093/europace/eun272
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

SHORT COMMUNICATIONS

A ‘Regularly Irregular’ tachycardia: what is the diagnosis?

François Tournoux1,2,3,4,5,*, Dominique Pavin1,2,3,4, Aude Solnon1,2,3,4 and Philippe Mabo1,2,3,4,*

1 CHU Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes F-35000, France; 2 Université de Rennes 1, LTSI, Rennes F-35000, France; 3 INSERM, U642, Rennes F-35000, France; 4 INSERM, CIC-IT 804, Rennes F-35000, France; 5 Hôpital Lariboisière, Service de Cardiologie, AP-HP, Université de Paris 7, Paris, France

We report the case of a 46-year-old female presented to the emergency room with sustained palpitations. Her ECG showed a narrow QRS regularly irregular tachycardia. This tachycardia was immediately terminated by a single dose of adenosine, and sinus rhythm was restored. Diagnosis of atrial tachycardia, orthodromic reciprocating tachycardia, and atrial nodal reentrant tachycardia (AVNRT) are discussed. An electrophysiological study was performed for further evaluation, and our final hypothesis was AVNRT with triple nodal pathways. A single application of radiofrequency energy in the posterior septum near the coronary sinus ostium effectively eliminated the tachycardia.

Key Words: AVNRT, Triple pathways

* Corresponding authors. Tel: +33 2 99 28 25 25; fax: 33 2 99 28 25 10. E-mail address: tournoux{at}gmail.com (F.T.) or philippe.mabo{at}chu-rennes.fr (P.M.)

Manuscript submitted 16 July 2008. Accepted after revision 8 September 2008.


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