A 'Regularly Irregular' tachycardia: what is the diagnosis?

Europace. 2008 Dec;10(12):1445-6. doi: 10.1093/europace/eun272. Epub 2008 Oct 3.

Abstract

We report the case of a 46-year-old female presented to the emergency room with sustained palpitations. Her ECG showed a narrow QRS regularly irregular tachycardia. This tachycardia was immediately terminated by a single dose of adenosine, and sinus rhythm was restored. Diagnosis of atrial tachycardia, orthodromic reciprocating tachycardia, and atrial nodal reentrant tachycardia (AVNRT) are discussed. An electrophysiological study was performed for further evaluation, and our final hypothesis was AVNRT with triple nodal pathways. A single application of radiofrequency energy in the posterior septum near the coronary sinus ostium effectively eliminated the tachycardia.

Publication types

  • Case Reports

MeSH terms

  • Catheter Ablation*
  • Diagnosis, Differential
  • Female
  • Heart Conduction System / abnormalities*
  • Humans
  • Middle Aged
  • Tachycardia, Atrioventricular Nodal Reentry / diagnosis*
  • Tachycardia, Atrioventricular Nodal Reentry / surgery*
  • Treatment Outcome