Successful Catheter Ablation for Paroxysmal Supraventricular Tachycardia with Two Alternating Cycle Lengths

Intern Med. 2024 Jan 1;63(1):93-96. doi: 10.2169/internalmedicine.1491-22. Epub 2023 May 17.

Abstract

A 62-year-old male was transferred to our hospital complaining of palpitations. His heart rate was 185/min. Electrocardiogram showed a narrow QRS regular tachycardia and the tachycardia changed spontaneously to another narrow QRS tachycardia with two alternating cycle lengths. The arrhythmia was stopped by the administration of adenosine triphosphate. Findings from electrophysiological study suggested that there was an accessory pathway (AP) and dual atrioventricular (AV) nodal pathways. After AP ablation, any other tachyarrythmias were not induced. We supposed that the tachycardia was paroxysmal supraventricular tachycardia involving AP and anterograde conduction alternating between slow and fast AV nodal pathways.

Keywords: accessory pathway; dual atrioventricular nodal pathway; paroxysmal supraventricular tachycardia; regularly irregular narrow QRS tachycardia.

Publication types

  • Case Reports

MeSH terms

  • Atrioventricular Node / surgery
  • Catheter Ablation*
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Tachycardia, Atrioventricular Nodal Reentry* / surgery
  • Tachycardia, Ventricular*