Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff- Parkinson-White syndrome: Uneven depression of accessory pathway.

Slides:

Advertisements

Similar presentations

Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff- Parkinson-White syndrome: Uneven depression of accessory pathway.

Advertisements

Tracing from a patient with Wolff–Parkinson–White (WPW) and documented supraventricular tachycardia. The first two cycles are preexcited and a 12-lead.

Clinical Intracardiac Electrophysiologic Testing: Technique, Diagnostic Indications, and Therapeutic Uses STEPHEN C. HAMMILL, M.D. Mayo Clinic Proceedings

Volume 92, Issue 3, Pages (September 1987)

Wolff-Parkinson-White syndrome due to a left atrial appendage–to–left ventricular connection: A case of a successful pathway elimination from inside of.

HeartRhythm Case Reports

The influence of His bundle pacing on tricuspid valve functioning using three- dimensional echocardiography Eriko Hasumi, MD, PhD, Katsuhito Fujiu, MD,

Incessant bundle branch reentrant ventricular tachycardia in a patient with corrected transposition of the great arteries Ken Kato, MD, Daigo Yagishita,

Atypical inferoseptal accessory pathway connection associated with an aneurysm of the coronary sinus: Insight from a three-dimensional combined image.

Peri–coronary sinus atrial flutter associated with prior slow pathway ablation Mitsunori Maruyama, MD, PhD, FHRS, Shunsuke Uetake, MD, PhD, Yasushi Miyauchi,

Paradoxical reflex bradycardia after epinephrine infusion for arrhythmia induction in the electrophysiology laboratory Timothy R. Larsen, DO, Karoly.

Ben Ng, MBBS, Robert W. Giles, MBBS, Zal Dastur, BSc, Mark A

Maged F. Nageh, MD,FHRS, Kamal Kotak, MD HeartRhythm Case Reports

Resolution of the functional retrograde right bundle branch block during antidromic atrioventricular reciprocating tachycardia Keiko Takahashi, MD, PhD,

Limitations of 12-lead electrocardiogram wide complex tachycardia algorithms in a patient with left atrial flutter and large myocardial infarction Carlos.

Claudio Hadid, MD, Sergio Gonzalez, MD, Jesús Almendral, MD, PhD

Isolated Wolff-Parkinson-White syndrome in identical twins

Use of intravenous sotalol in newborns with supraventricular tachycardia Hannah Kim, MD, Jennifer Wolff, PharmD, BCPPS, Aarti Dalal, DO, George F. Van.

Dual-loop biatrial concomitant macroreentrant tachycardia in a patient without previous history of surgery or ablation Song-Yun Chu, MD, Li-Bin Shi,

Unusual mechanism of complete atrioventricular block following atrial flutter ablation Frederic Georger, MD, Luc De Roy, MD, Camelia Sorea, Jean-Paul.

Atrial fibrillation originating from recipient left atrium after an orthotopic heart transplantation Auroa Badin, MD, Jaret Tyler, MD, FHRS, Steven J.

Successful demonstration of the detailed connection between the twin atrioventricular nodes and sling in a patient with asplenia syndrome Hitoshi Mori,

Isolation of the conduction between the Marshall bundle and distal coronary sinus and the entire coronary sinus for an atrial tachycardia after catheter.

Bradley D. Brochu, MD, Ahmed Abdi-Ali, MD, Jeffrey Shaw, MD, F

Successful catheter ablation using real-time ultrasound-assisted 3-D electroanatomical mapping system for atrioventricular accessory pathway in a 1-year-old.

Elisa Ebrille, MD, Fernando M. Contreras-Valdes, MD, Peter J

Volume 11, Issue 1, Pages (January 2014)

An unusual atrioventricular accessory pathway with an oblique course

Adenosine-sensitive atrial tachycardia originating from the anterior mitral annulus Dai Inagaki, MD, Rintaro Hojo, MD, Seiji Fukamizu, MD, PhD, Harumizu.

Cardiac arrest in an adolescent with Uhl’s anomaly: Two unusual cardiac arrhythmia mechanisms Jeffrey P. Moak, MD, Gail D. Pearson, MD, ScD, Bradley.

Macroreentrant form of an adenosine 5′-triphosphate–sensitive atrial tachycardia arising from the vicinity of the atrioventricular node involving the.

Volume 92, Issue 3, Pages (September 1987)

Paroxysmal 1:1 narrow complex tachycardia: What is the mechanism?

Cyclical sinus bradycardia and atrioventricular block induced by ticagrelor Victor Waldmann, MD, MPH, Mikael Laredo, MD, Anil Nigam, MD, MSc, Paul Khairy,

Cryoablation of an atrioventricular nodal reentrant tachycardia in a patient with an implanted deep brain stimulator Melanie Gunawardene, MD, Christian.

A rare mechanism of tachycardia and aberrancy

Expanding the electrical phenotype of NKX2-5 mutations: Ventricular tachycardia, atrial fibrillation, and complete heart block within one family Simone.

Intravenous sotalol for conversion of atrial flutter in infants

Atrial Tachycardia in a Patient With Fabry’s Disease

Bundle branch reentry: A novel mechanism for sustained ventricular tachycardia in Chagas heart disease Alvaro V. Sarabanda, MD, PhD, Wagner L. Gali,

Mapping of a postinfarction left ventricular aneurysm–dependent macroreentrant ventricular tachycardia Elad Anter, MD, Jianqing Li, MD, Cory M. Tschabrunn,

HeartRhythm Case Reports

Hiroko Asakai, MD, Laura Fenwick, BSc, Robert M. Hamilton, MD, FRCP(C)

Circular mapping recordings in a persistent left superior vena cava during atrial tachycardia: Was isolation achieved? Sandrine Venier, MD, Jason G.

Successful treatment of tachycardia-induced cardiomyopathy secondary to dual atrioventricular nodal nonreentrant tachycardia using cryoablation Harold.

Prenatal diagnosis and management of junctional ectopic tachycardia

A case of an incision-related single-loop intra-atrial reentrant tachycardia showing an eccentric atrial activation sequence and widely separate potentials.

Utility of entrainment pacing to clarify the circuit of macroreentrant tachycardia with dual early sites on activation maps Koichi Nagashima, MD, PhD,

Volume 77, Issue 4, Pages (April 1980)

Different rate-dependent responses between J waves and the notches on an epicardial local electrogram in a patient with idiopathic ventricular fibrillation

Slow pathway modification for treatment of pseudo-pacemaker syndrome due to first- degree atrioventricular block with dual atrioventricular nodal physiology

Catheter ablation of the slow pathway as a treatment for severe sinus node dysfunction in a patient with incessant atrioventricular nodal reentry tachycardia

Colin Yeo, MBBS, Martin Green, MD, Robert Lemery, MD, FHRS

Unusual severe hemodynamic failure associated with standard dose of intravenous flecainide for pharmacological cardioversion of atrial fibrillation Aref.

Peter Kabunga, MBChB, MRCP, George J. Klein, MD, FHRS, Raymond W

Mahaim pathway tachycardia versus bystander ventricular tachycardia: A distinction without a difference Michael S. Wu, MD, James E. Ip, MD, FHRS, George.

Clinical problem solving: Maneuvering around a narrow complex tachycardia in a patient with Mustard repair for transposition of the great arteries Nicholas.

Analysis of variable conduction ratios into the atrioventricular node during atrial flutter: Multilevel block theory Kazushi Tanaka, MD, PhD, FACC, Osamu.

Philip M. Chang, MD, FHRS, CEPS, Akash R

Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic.

Early repolarization syndrome: A case report focusing on dynamic electrocardiographic changes before ventricular arrhythmias and genetic analysis Vern.

Parsing a perplexing paroxysmal pathway

Two apparently remote types of ventricular tachycardia from a single right bundle branch focal source Jaromír Josiek, MD, Jaroslav Januška, MD, PhD,

Ablation of a symptomatic spontaneous automatic focus arising from an atriofascicular fiber Sandrine Venier, MD, Paul Khairy, MD, PhD, Bernard Thibault,

Left atrial access via an unroofed coronary sinus to eliminate fast/slow atypical AVNRT: A case report Gustavo X. Morales, MD, Yousef H. Darrat, MD,

Acquired right atrial appendage to right ventricle accessory pathway in a lateral tunnel Fontan patient: Successful ablation via transconduit approach

Joao Pimenta, M.D., Manoel Miranda, M.D., Lélio A. Silva, M.D. CHEST

Social anxiety provoked by speech-induced atrial tachycardia

Jeffrey Munro, DO, Win-Kuang Shen, MD, FHRS, Komandoor Srivathsan, MD

A wide QRS complex tachycardia utilizing an atypical accessory pathway in latent Wolff- Parkinson-White syndrome: Manifestation of anterograde conduction.

Presentation transcript:

Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff- Parkinson-White syndrome: Uneven depression of accessory pathway conduction Oscar A. Pellizzón, MD, PhD, Manlio F. Márquez, MD, Mario D. González, MD, Sebastián Nannini, MD, Rodolfo Leiva, MD, Antonia Catalano, MD, Pedro Iturralde, MD HeartRhythm Case Reports Volume 2, Issue 6, Pages 506-510 (November 2016) DOI: 10.1016/j.hrcr.2016.08.001 Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 1 A: The 12-lead surface electrocardiogram before flecainide. B: Disappearance of antegrade conduction through the accessory pathway after the onset of flecainide. HeartRhythm Case Reports 2016 2, 506-510DOI: (10.1016/j.hrcr.2016.08.001) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 2 A: Supraventricular tachycardia before administration of flecainide with cycle length of 220 msec and interval RP of 80 msec. B: Incessant supraventricular tachycardia developed during flecainide administration. The RP interval has now increased to 120 msec. C: Following administration of intravenous adenosine there was transient termination of the tachycardia with rapid reinitiation in the absence of atrial or ventricular premature beats. Shortening of the sinus cycle length from 940 to 790 msec was enough to restart the tachycardia in the absence of premature beats. Arrows point to the retrograde P waves. Dotted lines indicate the R-P intervals. HeartRhythm Case Reports 2016 2, 506-510DOI: (10.1016/j.hrcr.2016.08.001) Copyright © 2016 Heart Rhythm Society Terms and Conditions

Figure 3 A: Electrocardiographic leads I, II, V1, and V5 are displayed along with electrograms recorded from the His bundle (HB), coronary sinus (CS), and right ventricle (RV) at a paper speed of 50 mm/sec. Pacing from proximal CS at a cycle length of 600 msec results in full preexcitation with negative delta wave in V1 and II consistent with a right inferior paraseptal accessory A-V pathway. After introducing a single extrastimulus with a coupling interval of 400 msec, antegrade block over the accessory A-V pathway allows exclusive antegrade conduction over the atrioventricular (AV) node and induction of an orthodromic AV reentrant tachycardia with a cycle length of 280 msec. B: Same recording as panel A (50 mm/sec) with fewer signals for clarity (leads V1 and V5, HB, and CS recordings). Earliest retrograde atrial activation was recorded from the proximal coronary sinus (CSp) owing to retrograde activation through the accessory A-V pathway. HeartRhythm Case Reports 2016 2, 506-510DOI: (10.1016/j.hrcr.2016.08.001) Copyright © 2016 Heart Rhythm Society Terms and Conditions