Parsing a perplexing paroxysmal pathway

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Presentation transcript:

Parsing a perplexing paroxysmal pathway Elaine Wan, MD, José Dizon, MD, William Whang, MD, Hasan Garan, MD HeartRhythm Case Reports Volume 1, Issue 6, Pages 453-456 (November 2015) DOI: 10.1016/j.hrcr.2015.06.013 Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 1 A 12-lead electrocardiogram of supraventricular tachycardia. HeartRhythm Case Reports 2015 1, 453-456DOI: (10.1016/j.hrcr.2015.06.013) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 2 A: Right ventricular (RV) pacing at 600 milliseconds at the start of the study showed ventriculoatrial dissociation. B: Tachycardia with intracardiac electrograms showing eccentric atrial activation sequence. C: Programmed premature ventricular complexes were able to terminate the tachycardia without activating the atrium. D: Entrainment maneuvers by pacing from the RV demonstrated a VAV response. HeartRhythm Case Reports 2015 1, 453-456DOI: (10.1016/j.hrcr.2015.06.013) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 3 A: Programmed premature ventricular complexes (PVCs) appropriately timed during normal sinus rhythm demonstrated retrograde conduction over the accessory pathway. B: A programmed PVC during normal sinus rhythm resulting in ventricular reentrant beat and conduction up the accessory pathway. C: Catheter-induced PVC in the left ventricle shows retrograde conduction over the accessory pathway. HeartRhythm Case Reports 2015 1, 453-456DOI: (10.1016/j.hrcr.2015.06.013) Copyright © 2015 Heart Rhythm Society Terms and Conditions