CHALLENGE OF THE WEEK See Answer to January 22nd Following Question Amit Noheria, MBBS, SM A 51-year-old woman with asthma and recurrent palpitations for one and half year presented to Emergency Department in wide complex tachycardia and was electrically cardioverted. In the electrophysiology laboratory, both wide complex and narrow complex tachycardias were inducible with programmed electric stimu- lation. What can be surmised about the tachycardia shown in Figure based on the transition that occurred during manipulation of the mapping/ablation catheter across the tricuspid valve? Figure. Twelve-lead electrocardiogram and intracardiac electrograms (recorded at 100 mm/s) showing the transition from wide-complex to narrow-complex tachycardia. ABL indicates ablation/mapping; CS, coronary sinus; d, distal; m, mid; p, proximal; and RVa, right ventricular apex. Answer Options A. Dual tachycardia is present: ventricular tachycardia and supraventricular tachycardia B. Dual tachycardia is present: antidromic reentry tachycardia (using atriofas- cicular/nodofascicular tract) and atrioventricular nodal reentry tachycardia Circ Arrhythm Electrophysiol C. Accessory pathway (atriofascicular/nodofascicular) is not participatory in the is available at http://circep. tachycardia ahajournals.org. D. There is atrial tachycardia with bystander atriofascicular/nodofascicular tract © 2018 American Heart E. There is atrioventricular nodal reentry tachycardia with bystander atriofas- Association, Inc. cicular/nodofascicular tract Circ Arrhythm Electrophysiol. 2018;11:e006206. DOI: 10.1161/CIRCEP.118.006206
Circulation: Arrhythmia & Electrophysiology – Wolters Kluwer Health
Published: Feb 1, 2018
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