Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Nov 1980
Case ReportsIncessant reciprocating atrioventricular tachycardia. Factors playing a role in the mechanism of the arrhythmia.
The case of a patient suffering from incessant supraventricular tachycardia is presented. The electrophysiological study showed the presence of an accessory atrioventricular (A-V) bundle with nodal-like properties and long conduction times. This structure was used as the retrograde arm of the tachycardia circuit. ⋯ During handgrip exercise a sustained tachycardia developed immediately. During ventricular stimulation a dual atrial response to a single paced ventricular premature beat was repeatedly observed, proving the availability of two separate A-V pathways for retrograde conduction. The case illustrates the labile nature of this type of accessory pathway, and suggests that autonomic changes can play an important role in the initiation, maintenance, termination, or even spontaneous cure of tachycardia in patients with this anomaly.