Exercise-induced double (atrial and ventricular) tachycardia: a report of three cases

Exercise-induced double tachycardia, i.e., the simultaneous occurrence of atrial and ventricular tachycardia, is described in three patients: one patient had coronary artery disease; the other two were young and had no apparent heart disease. One of the latter patients later died suddenly. Double tachycardia could not be initiated by programmed atrial or ventricular stimulation. In two patients atrial tachycardia always preceded ventricular tachycardia and, in one patient, ventricular tachycardia was terminated by the administration of adenosine triphosphate. Reentry does not seem to be the underlying mechanism for these arrhythmias; abnormal automaticity or triggered activity may be the mechanism.