Uncommon presentation of a common arrhythmia

Area of Science:

• Electrophysiology
• Cardiology

Background:

• Reentrant atrioventricular nodal tachycardia (AVNRT) is a common supraventricular tachycardia.
• Accurate diagnosis relies on electrophysiological studies (EPS).

Observation:

• This case report details a patient where standard conduction assessments at rest were misleading.
• Atrioventricular (AV) and ventriculoatrial (VA) conduction parameters did not reliably indicate the presence of AVNRT.

Findings:

• Resting electrophysiological parameters for AV and VA conduction can be unreliable in diagnosing AVNRT.
• The presence of reentrant circuits may not always be evident under baseline conditions.

Implications:

• Clinicians should exercise caution when interpreting resting conduction data during EPS for AVNRT.
• Further investigation or provocative maneuvers may be necessary if AVNRT is suspected despite non-diagnostic resting findings.