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Updated: Aug 11, 2026

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Published on: February 22, 2018
Reentrant tachycardia using two discrete atrioventricular nodes and a concealed atriofascicular pathway
A M Dubin1, K Desai, G F Van Hare
1Stanford University, Stanford, CA, USA. amdubin@leland.stanford.edu
This study reports a rare case of supraventricular tachycardia in a young woman, successfully treated by ablating a unique accessory pathway. The procedure eliminated the tachycardia without affecting the dual atrioventricular nodes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Case Reports
Background:
- Supraventricular tachycardia (SVT) can arise from complex electrical abnormalities in the heart.
- Dual atrioventricular (AV) nodes are an exceptionally rare congenital anomaly.
Observation:
- A 21-year-old woman presented with recurrent SVT.
- She had complex congenital heart anomalies including superior-inferior ventricles and ventricular inversion.
- Electrophysiological study revealed two discrete AV nodes and a concealed atriofascicular pathway.
Findings:
- The SVT utilized both AV nodes in the antegrade direction and the accessory pathway in retrograde conduction.
- Endocardial mapping identified the dual AV nodes and the accessory pathway.
- Radiofrequency ablation of the accessory pathway successfully terminated inducible tachycardia.
Implications:
- This case demonstrates a unique mechanism of reentrant SVT involving dual AV nodes and an accessory pathway.
- Successful ablation highlights the efficacy of targeted catheter ablation for complex arrhythmias.
- Understanding such rare anatomies is crucial for effective arrhythmia management in congenital heart disease.
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