Clinical case 2: interpreting atrial activation during a critical maneuver
Mastering Supraventricular Tachycardia Diagnostics in the Electrophysiology Lab, Elsevier, ss.171-174, 2026
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/b978-0-443-36430-3.00003-5
- Yayınevi: Elsevier
- Sayfa Sayıları: ss.171-174
- Anahtar Kelimeler: accessory pathway, atrioventicular nodal reentrant tachycardia, atrioventricular reciprocating tachycardia, bystander accessory pathway, Narrow complex tachycardia, supraventricular tachycardia, supraventricular tachycardia diagnostics, ventricular overdrive pacing
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
This chapter examines a case of tachycardia in a 32-year-old woman with recurrent palpitations, emphasizing the interpretation of atrial activation during ventricular overdrive pacing (VOP). The sustained narrow complex tachycardia (NCT) and subsequent maneuvers confirmed the diagnosis of typical atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander left-sided accessory pathway (AP). A critical diagnostic feature, the V-A-V response observed upon cessation of VOP, definitively excluded atrial tachycardia (AT). Intracardiac tracings showed changes in atrial activation sequences during pacing, explained by retrograde conduction via the AP without involving it in the tachycardia circuit. The baseline tachycardia circuit and post-pacing interval (PPI) analysis reinforced this conclusion. This case highlights the role of meticulous electrophysiological assessment in distinguishing between AVNRT, atrioventricular reentrant tachycardia (AVRT), and AT, leveraging findings such as PPIs and eccentric atrial activation caused by passive AP propagation.