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Europace Advance Access published online on March 15, 2007
Europace, doi:10.1093/europace/eum037
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

CASE REPORT

Atrial tachycardia with slow pathway conduction mimicking typical atrioventricular nodal reentrant tachycardia

Takumi Yamada*, Jose F. Huizar, Hugh T. McElderry and G. Neal Kay

Division of Cardiovascular Diseases, Cardiac Rhythm Management Laboratory, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd AVE S, Birmingham, AL 35294-0019, USA

A 68-year-old woman with palpitations underwent electrophysiologic testing. During burst atrial pacing the PR interval exceeded the RR interval and induced a supraventricular tachycardia consistent with a typical AV nodal reentrant tachycardia (AVNRT). Radiofrequency ablation of the slow pathway during the tachycardia immediately produced 2 : 1 AV conduction. After slow AV nodal pathway ablation an atrial tachycardia (AT) remained inducible with the earliest atrial activation around the HB region. Radiofrequency ablation at the site of earliest atrial activation interrupted the AT without AV block. AT originating from the HB region with slow pathway conduction may mimic typical AVNRT.

Key Words: Atrial tachycardia, Slow pathway, Atrioventricular nodal reentrant tachycardia, Radiofrequency catheter ablation

* Corresponding author: Tel: +1 205 975 4724; fax: +1 205 975 4720. E-mail address: takumi-y{at}fb4.so-net.ne.jp

Manuscript submitted 25 November 2006. Accepted after revision 14 February 2007.


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