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Case Reports
. 2021 Nov 9;8(2):89-92.
doi: 10.1016/j.hrcr.2021.11.006. eCollection 2022 Feb.

2:1 Pulsus and electrical alternans during atrioventricular reciprocating tachycardia in a healthy young man: A case report

Nicolò Martini  1 , Sergio Cannas  2 , Francesco Guglielmi  2 , Claudio Sperotto  2 , Luca De Mattia  3 , Bortolo Martini  2
Affiliations
Case Reports

2:1 Pulsus and electrical alternans during atrioventricular reciprocating tachycardia in a healthy young man: A case report

Nicolò Martini et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Accessory pathway; Atrioventricular reciprocating tachycardia; Electrical alternans; Pulsus alternans; Supraventricular tachycardia; Tachycardiomyopathy.

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Figures

Figure 1
Figure 1
A: A 12-lead electrocardiogram of the patient showing a narrow QRS tachycardia at a heart rate of 165 beats/min and retrograde p waves (circle), best seen in inferior limb leads. Electrical alternans, namely the beat-to-beat alternation of the QRS amplitude, can best be appreciated in lead V1 (arrows). B: A 12-lead electrocardiogram of the patient at sinus rhythm. Retrograde p waves are no longer seen.
Figure 2
Figure 2
Parasternal long-axis with M-mode view at 2-dimensional echocardiogram. A: A 2:1 complete opening of the aortic valve can be seen. B: Mitral valve with a 2:1 incomplete opening and a subsequent inadequate ventricular filling.
Figure 3
Figure 3
Surface and endocavitary tracings during transesophageal electrophysiological study (paper speed 25 mm/s). A: Supraventricular tachycardia (SVT) induction with retrograde p waves seen after the QRS complex (circles). Positive retrograde p waves in leads II, III, aVF, and V1 (red circles) and negative retrograde p waves in leads V5, V6, and aVL (blue circles) are consistent with an orthodromic reciprocating tachycardia (ORT) using a left lateral accessory pathway. B: A ventriculoatrial interval of 100 ms (red lines) during SVT suggests ORT.
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References

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