Antidromic AVRT with changing His activation. What is the mechanism?
Anand Manickavasagam1, Sirish Chandra Srinath Patloori1, Hariharan Narasaiyan1
1Department of Cardiology, Christian Medical College, Vellore, Tamilnadu, India.
Journal of Electrocardiology
|July 23, 2023
Summary
This study details a rare case of antidromic atrioventricular reentrant tachycardia (AVRT) linked to an atriofascicular pathway. A unique finding was transient VA dissociation during tachycardia in a patient with impaired heart function.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Atrioventricular reentrant tachycardia (AVRT) can involve various accessory pathways.
- Atriofascicular pathways are less common causes of AVRT.
- Coronary sinus anomalies can influence cardiac electrophysiology.
Observation:
- A patient with an atretic coronary sinus os presented with antidromic AVRT.
- The patient exhibited left ventricular dysfunction and rate-related left bundle branch block aberrancy.
- Electrophysiology study revealed transient VA dissociation during antidromic tachycardia.
Findings:
- The case highlights an unusual presentation of antidromic AVRT associated with an atriofascicular pathway.
- The presence of an atretic coronary sinus os was a significant anatomical finding.
- Transient VA dissociation during tachycardia suggests complex electrophysiological interactions.
Implications:
- This case expands the understanding of AVRT mechanisms involving atriofascicular pathways.
- It underscores the importance of considering anatomical variations in diagnosing arrhythmias.
- Further research into the mechanisms of VA dissociation in AVRT is warranted.
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