Case details:
A 30-year-old man with a structurally normal heart was referred to us
with a 2-year history of recurrent episodes of rapid paroxysmal
palpitations. A few episodes required hospitalization and were
terminated with intravenous diltiazem. During electrophysiology (EP)
study done twice before in other hospitals, the patient was diagnosed as
typical atrioventricular nodal reentrant tachycardia (AVNRT) and
underwent radiofrequency ablation of the slow pathway. However, the
episodes recurred.
Because of the patient’s persistent symptoms, an EP study was performed
again. Tachycardia was easily induced using atrial extrastimuli,
ventricular extrastimuli and with rapid atrial pacing.
Figure 1: Induction of tachycardia with atrial extrastimuli.
Figure 2: Atrial overdrive pacing during the tachycardia.
Figure 1. Induction of tachycardia with atrial extrastimuli.