Misinterpretation of Dual Atrioventricular Nodal Non-Reentrant Tachycardia as Ventricular Tachycardia and Implantation of ICD Followed by Inappropriate Shocks

Türkmen, Yusuf

doi:10.14744/anatoljcardiol.2020.73709

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Inappropriate therapies are frequent in patients with ICDs and are associated with adverse outcomes, including increased mortality. Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common reentrant narrow complex tachycardia (NCT) and a cause of inappropriate therapies in these patients 1–3 . The differential diagnosis of NCT with ventriculoatrial (VA) dissociation or variable block to the atrium includes junctional ectopic tachycardia (JET), AVNRT with a block in the upper (proximal) common pathway (UCP), orthodromic nodofascicular (NF)/nodoventricular (NV) re‐entry, and a focal tachycardia from the proximal or distal His–Purkinje system (HPS) 4–10 …”

Section: Discussionmentioning

confidence: 99%

An interesting response to His‐synchronous ventricular stimulation: What is the mechanism of this supraventricular tachycardia?

Turhan¹,

Hidayet

Tunçez

et al. 2022

Cardiovasc electrophysiol

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Section: Discussionmentioning

confidence: 99%

An interesting response to His‐synchronous ventricular stimulation: What is the mechanism of this supraventricular tachycardia?

Turhan¹,

Hidayet

Tunçez

et al. 2022

Cardiovasc electrophysiol

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The great deceiver: a case series of ‘double fire’ atrioventricular nodal response

Leão

Luermans

Vernooy

et al. 2023

European Heart Journal - Case Reports

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Background The “double fire” (DF) atrioventricular (AV) nodal response is a rare mechanism of two ventricular electrical activations following a single atrial beat due to dual AV node physiology. DF AV nodal response is often misdiagnosed and may lead to unnecessary and sometimes risky interventions. Case summary We describe a series of three cases with distinct clinical manifestations of DF AV nodal response: Patient 1 remained symptomatic after slow pathway modification for common AV nodal re-entry tachycardia. Patient 2 was misdiagnosed as having junctional bigeminy and developed heart failure with reduced left ventricle ejection fraction. Patient 3 was misdiagnosed as having atrial fibrillation (AF) and underwent two pulmonary vein isolation (PVI) procedures, without clinical improvement. All patients underwent an electrophysiological study (EPS) during which DF AV nodal response was confirmed and treated with radio frequency ablation of the slow pathway. All patients were afterwards relieved from their symptoms. Discussion and Conclusion DF AV nodal response is a rare electrophysiological phenomenon which can be clinically misinterpreted as other common arrhythmias, such as premature junctional bigeminy or AF and can contribute to tachycardia induced cardiomyopathy. Typical ECG- and EPS-derived findings can be indicative for DF AV nodal response. DF AV nodal response can be easily and effectively treated by slow pathway ablation.

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Misinterpretation of Dual Atrioventricular Nodal Non-Reentrant Tachycardia as Ventricular Tachycardia and Implantation of ICD Followed by Inappropriate Shocks

Cited by 2 publications

References 8 publications

An interesting response to His‐synchronous ventricular stimulation: What is the mechanism of this supraventricular tachycardia?

An interesting response to His‐synchronous ventricular stimulation: What is the mechanism of this supraventricular tachycardia?

The great deceiver: a case series of ‘double fire’ atrioventricular nodal response

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