A case of heart failure complicated with double ventricular response triggered by beta blocker

Validation of dual atrioventricular nodal physiology in dual atrioventricular nodal non‐reentrant tachycardia via adenosine triphosphate injection during atrial pacing: A novel insight into the role of leftward inferior extension

“…On analysis of documented DAVNNT cases with prior SP ablation histories, we observe that repeated SP ablation at the right atrial septum has consistently yielded positive outcomes. The underlying theory suggests that SP re‐emergence combined with antegrade conduction delay and retrograde conduction damage from initial SP ablation potentially culminates in DAVNNT 13–15 . In this particular instance, traditional SP, encompassing RIE, did not resurface.…”

“…Historically, literature has identified the posteroseptal right atrium as the most effective ablation site for DAVNNT, mirroring the typical SP. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Notably, none of the previous studies [13][14][15] In this particular instance, traditional SP, encompassing RIE, did not resurface. We deduced this considering that both RF ablation and cryoablation within the right atrial septum did not impact the DAVNNT, while RF ablation at the left atrial septum successfully neutralized it.…”

“…Accurate DAVNNT diagnosis and treatment are paramount, especially considering that repeated DAVNNT episodes may lead to tachycardia-induced cardiomyopathy. [1][2][3][5][6][7][8][9][10][13][14][15]18 Crucially, DAVNNT remains a treatable arrhythmia, primarily addressed with SP ablation.…”

“…DAVNNT, a rare arrhythmia, is characterized by double antegrade AV nodal conduction. Historically, literature has identified the posteroseptal right atrium as the most effective ablation site for DAVNNT, mirroring the typical SP 1–19 . Notably, none of the previous studies have documented successful DAVNNT treatment via left atrial ablation.…”

“…We propose that ATP injection during atrial pacing could serve as a potential diagnostic tool for both DAVNNT and AVNRT patients. Accurate DAVNNT diagnosis and treatment are paramount, especially considering that repeated DAVNNT episodes may lead to tachycardia‐induced cardiomyopathy 1–3,5–10,13–15,18 . Crucially, DAVNNT remains a treatable arrhythmia, primarily addressed with SP ablation.…”