Occurrence of atrioventricular block during supraventricular tachycardia: What is its possible mechanism?

Research output: Contribution to journalArticle

Abstract

A female patient was admitted to our hospital for catheter ablation arising from paroxysmal supraventricular tachycardia (PSVT). In the laboratory, PSVT (the earliest retrograde atrial activation at the coronary sinus ostium) with intermittent atrioventricular (AV) block could be induced repeatedly. The tachycardia could be terminated during ventricular pacing without retrograde conduction to the atria. Therefore, orthodromic AV reciprocating tachycardia (AVRT) and atrial tachycardia (AT) could be ruled out and AV nodal re-entrant tachycardia (AVNRT) was subsequently considered. Initial attempts using slow or intermediate AV nodal ablation failed to cure the tachycardia. We considered the possibility of orthodromic AV reciprocating tachycardia (AVRT) with AV block occurring during the tachycardia. The tachycardia was successfully terminated during the ablation of the right posteroseptal pathway at the coronary sinus ostium. We hypothesized about the possible explanation that might help to clarify the phenomenon of AV block during SVT in order to provide some guidance to other clinicians confronted with similar patient challenges in the future.

Original languageEnglish
Pages (from-to)108-111
Number of pages4
JournalJournal of the Chinese Medical Association
Volume77
Issue number2
DOIs
Publication statusPublished - Feb 2014

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Supraventricular Tachycardia
Atrioventricular Block
Tachycardia
Reciprocating Tachycardia
Paroxysmal Tachycardia
Coronary Sinus
Catheter Ablation

Keywords

  • Atrioventricular block
  • Catheter ablation
  • Supraventricular tachycardia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Occurrence of atrioventricular block during supraventricular tachycardia: What is its possible mechanism?",
abstract = "A female patient was admitted to our hospital for catheter ablation arising from paroxysmal supraventricular tachycardia (PSVT). In the laboratory, PSVT (the earliest retrograde atrial activation at the coronary sinus ostium) with intermittent atrioventricular (AV) block could be induced repeatedly. The tachycardia could be terminated during ventricular pacing without retrograde conduction to the atria. Therefore, orthodromic AV reciprocating tachycardia (AVRT) and atrial tachycardia (AT) could be ruled out and AV nodal re-entrant tachycardia (AVNRT) was subsequently considered. Initial attempts using slow or intermediate AV nodal ablation failed to cure the tachycardia. We considered the possibility of orthodromic AV reciprocating tachycardia (AVRT) with AV block occurring during the tachycardia. The tachycardia was successfully terminated during the ablation of the right posteroseptal pathway at the coronary sinus ostium. We hypothesized about the possible explanation that might help to clarify the phenomenon of AV block during SVT in order to provide some guidance to other clinicians confronted with similar patient challenges in the future.",
keywords = "Atrioventricular block, Catheter ablation, Supraventricular tachycardia",
author = "Cheng, {Ho Shun} and Chen, {Wei Ta} and Huang, {Jen Hung} and Hsieh, {Ming Hsiung}",
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T2 - What is its possible mechanism?

AU - Cheng, Ho Shun

AU - Chen, Wei Ta

AU - Huang, Jen Hung

AU - Hsieh, Ming Hsiung

PY - 2014/2

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N2 - A female patient was admitted to our hospital for catheter ablation arising from paroxysmal supraventricular tachycardia (PSVT). In the laboratory, PSVT (the earliest retrograde atrial activation at the coronary sinus ostium) with intermittent atrioventricular (AV) block could be induced repeatedly. The tachycardia could be terminated during ventricular pacing without retrograde conduction to the atria. Therefore, orthodromic AV reciprocating tachycardia (AVRT) and atrial tachycardia (AT) could be ruled out and AV nodal re-entrant tachycardia (AVNRT) was subsequently considered. Initial attempts using slow or intermediate AV nodal ablation failed to cure the tachycardia. We considered the possibility of orthodromic AV reciprocating tachycardia (AVRT) with AV block occurring during the tachycardia. The tachycardia was successfully terminated during the ablation of the right posteroseptal pathway at the coronary sinus ostium. We hypothesized about the possible explanation that might help to clarify the phenomenon of AV block during SVT in order to provide some guidance to other clinicians confronted with similar patient challenges in the future.

AB - A female patient was admitted to our hospital for catheter ablation arising from paroxysmal supraventricular tachycardia (PSVT). In the laboratory, PSVT (the earliest retrograde atrial activation at the coronary sinus ostium) with intermittent atrioventricular (AV) block could be induced repeatedly. The tachycardia could be terminated during ventricular pacing without retrograde conduction to the atria. Therefore, orthodromic AV reciprocating tachycardia (AVRT) and atrial tachycardia (AT) could be ruled out and AV nodal re-entrant tachycardia (AVNRT) was subsequently considered. Initial attempts using slow or intermediate AV nodal ablation failed to cure the tachycardia. We considered the possibility of orthodromic AV reciprocating tachycardia (AVRT) with AV block occurring during the tachycardia. The tachycardia was successfully terminated during the ablation of the right posteroseptal pathway at the coronary sinus ostium. We hypothesized about the possible explanation that might help to clarify the phenomenon of AV block during SVT in order to provide some guidance to other clinicians confronted with similar patient challenges in the future.

KW - Atrioventricular block

KW - Catheter ablation

KW - Supraventricular tachycardia

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