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Updated: May 22, 2026

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
Published on: February 17, 2018
The Not-So-Fast Tachycardia: A Paradoxical Rhythm Leading to Cardiomyopathy
Moez Alnazeer1, Carson Costa2, Jerry Fan1
1Division of Cardiology, Baylor Scott and White Health, Temple, Texas, USA.
Case Summary:
An 88-year-old man with baseline sinus bradycardia and bifascicular block developed an incessant rhythm at 97 to 98 beats/min without discernible P waves and QRS morphology identical to baseline. Holter monitoring confirmed marked rate invariance. Echocardiography revealed new left ventricular systolic dysfunction (left ventricular ejection fraction 35%-40%; previously normal). Electrophysiology study demonstrated very slow typical (slow-fast) atrioventricular nodal re-entry tachycardia; slow-pathway ablation restored sinus rhythm, and left ventricular ejection fraction normalized within 3 months.
Take-Home Messages:
A near-100 beats/min junctional-appearing rhythm may represent atrioventricular nodal-dependent reentry. When incessant and associated with new cardiomyopathy, electrophysiology study can diagnose the mechanism and enable curative ablation.
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