Regular tachycardia despite Wenckebach atrioventricular conduction

Occam’s Razor: Two Arrhythmias in a Single Heart?

“…During electrophysiological studies, accelerated atrial pacing creating 3:2 Wenckebach creates a regular ventricular rate in 1% of trials. 1 In our own case, the PP interval is 400 milliseconds and the ΔPR is 190 milliseconds, not exactly twice the ΔPR. Careful analysis reveals that the RR interval is not exactly regular.…”

“…In the first report of regular AT despite Wenckebach conduction, 1 a PP interval approximating 380 milliseconds and a ΔPR of 190 milliseconds (from 160 to 350 milliseconds for the 2 conducted beats) created a regular ventricular rate of 106 bpm. In the second report, 2 a PP interval of 700 milliseconds and a PR increasing from 250 to 600 milliseconds (ΔPR 350 milliseconds) produced a regular ventricular rhythm.…”

Clinical Classification of Rare Cardiovascular Diseases and Disorders: 2018 Update

“…As an example, a patient with ARVC of an autosomal dominant inheritance pattern, due to plakophilin-2 mutations and frequent arrhythmias should be listed in class III (group number 4) [70]. Arrhythmias in specific clinical settings, among other clinical conditions, include patients with arrhythmias as complications of or related to medical treatment which causes difficulties in diagnostics or management [71][72][73][74][75][76][77][78][79][80][81][82][83].…”