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A 'Regularly Irregular' tachycardia: what is the diagnosis?
François Tournoux1, Dominique Pavin, Aude Solnon
1CHU Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes F-35000, France. tournoux@gmail.com
Summary
A patient experienced sustained palpitations due to a heart rhythm disorder. Adenosine successfully terminated the episode, and radiofrequency ablation of a triple nodal pathway effectively treated the atrial nodal reentrant tachycardia (AVNRT).
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Palpitations are a common reason for emergency room visits.
- Tachycardias require accurate diagnosis and effective treatment.
Observation:
- A 46-year-old female presented with sustained palpitations.
- ECG revealed a narrow QRS regularly irregular tachycardia.
- Adenosine terminated the tachycardia, restoring sinus rhythm.
Findings:
- Differential diagnosis included atrial tachycardia and orthodromic reciprocating tachycardia.
- Electrophysiological study suggested AVNRT with triple nodal pathways.
- Radiofrequency ablation in the posterior septum successfully eliminated the tachycardia.
Implications:
- This case highlights the diagnostic challenges in tachycardia management.
- Successful radiofrequency ablation offers a curative option for complex AVNRT.
- Understanding nodal pathways is crucial for effective arrhythmia treatment.
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