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. 2023 May 9:15:101866.
doi: 10.1016/j.jaccas.2023.101866. eCollection 2023 Jun 7.

Dual Atrioventricular Nodal Non-Re-Entrant Tachycardia

David M Harmon  1 , Robert C Ward  1 , Abhishek J Deshmukh  1
Affiliations

Dual Atrioventricular Nodal Non-Re-Entrant Tachycardia

David M Harmon et al. JACC Case Rep. .

Abstract

A patient presented with symptoms of palpitations. Her standard 12-lead electrocardiogram captured 3 potential causes of her symptoms (premature atrial contractions, junctional rhythm, and narrow complex tachycardia). Further workup uncovered dual atrioventricular node physiology with 1:2 sinus conduction and resultant alternating QRS from a slow and fast conduction pathway. (Level of Difficulty: Intermediate.).

Keywords: ectopy; electrocardiogram; supraventricular arrhythmia.

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Conflict of interest statement

Dr Deshmukh has served as a consultant for GE Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Holter Monitor and 12-Lead Electrocardiogram With Ladder Diagram (A) Baseline sinus rhythm with (B) an intermittent junctional rhythm blocking sinus-activated beats. (C) Premature atrial contractions interrupt sinus rhythm leading brief supraventricular tachycardia followed by a sinus-activated narrow complex tachycardia with 2 narrow QRS complex morphologies. (D) Each of these is demonstrated on 12-lead electrocardiography. Blue arrow indicates blocked sinus beat.
See this image and copyright information in PMC

References

    1. Wang N.C., Shah H., Jain S.K., Saba S. Dual atrioventricular nodal nonreentrant tachycardia with alternating 1:1 and 1:2 AV conduction: mechanistic hypotheses and total suppression using right atrial pacing. Ann Noninvasive Electrocardiol. 2013;18(2):199–203. - PMC - PubMed