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Case Reports
. 2024 Nov;35(11):2254-2257.
doi: 10.1111/jce.16430. Epub 2024 Sep 10.

Decremental properties of a concealed nodoventricular pathway

Koumei Onuki  1 , Koichi Nagashima  2 , Yasuharu Matsunaga-Lee  3 , Masato Fukunaga  1 , Kenichi Hiroshima  1 , Kenji Ando  1 , Melvin M Scheinman  4
Affiliations
Case Reports

Decremental properties of a concealed nodoventricular pathway

Koumei Onuki et al. J Cardiovasc Electrophysiol. 2024 Nov.

Abstract

Introduction: The decremental properties of the nodoventricular pathway (NVP) are uncertain.

Methods and results: During short RP supraventricular tachycardia, a His-refractory premature ventricular contraction (PVC) consistently terminated the tachycardia without atrial capture immediately after the PVC. Whereas a slightly earlier PVC failed to reset the subsequent His but terminated the tachycardia without atrial capture one cycle later.

Conclusion: These observations are diagnostic of slow-fast atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander concealed-NVP and can be explained by decremental properties in the NVP itself; greater prematurity of the PVC resulted in more decremental conduction over the NVP, causing the AVNRT termination one cycle later.

Keywords: accessory pathways; atrioventricular nodal reentrant tachycardia; nodoventricular pathways; premature ventricular contraction during His refractoriness.

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References

REFERENCES

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