Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism?
33 year old gentleman has undergone an electrophysiology study for recurrent paroxysmal palpitation. During one of the episodes of palpitation a regular narrow QRS tachycardia was documented which has terminated with intravenous adenosine. Baseline electrocardiogram did not show any pre-excitation....
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| Format: | Article |
| Language: | English |
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Elsevier
2020-01-01
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| Series: | Indian Pacing and Electrophysiology Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629219301421 |
| _version_ | 1819027241832546304 |
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| author | Krishna Kumar Mohanan Nair Narayanan Namboodiri Sreevilasam Pushpangadhan Abhilash Mukund Prabhu Debasish Das Ajitkumar Valaparambil |
| author_facet | Krishna Kumar Mohanan Nair Narayanan Namboodiri Sreevilasam Pushpangadhan Abhilash Mukund Prabhu Debasish Das Ajitkumar Valaparambil |
| author_sort | Krishna Kumar Mohanan Nair |
| collection | DOAJ |
| description | 33 year old gentleman has undergone an electrophysiology study for recurrent paroxysmal palpitation. During one of the episodes of palpitation a regular narrow QRS tachycardia was documented which has terminated with intravenous adenosine. Baseline electrocardiogram did not show any pre-excitation. Atrial-His (AH) and His-Ventricular (HV) intervals were normal at baseline. There was no evidence of dual atrioventricular (AV) nodal physiology. Earliest atrial electrogram during ventricular pacing was recorded at coronary sinus (CS) 9,10 dipoles placed at CS OS region. Narrow QRS tachycardia with cycle length (TCL) of 400 ms and earliest retrograde atrial activation at CS 9,10 dipoles was induced with programmed ventricular stimulation. Ventricular overdrive (VOD) pacing was performed at 30 ms shorter than TCL during the tachycardia (Fig: 1). What is the mechanism of tachycardia? Keywords: Entrainment, Orthodromic his capture, AV reentry, Narrow QRS tachycardia |
| first_indexed | 2024-12-21T05:39:21Z |
| format | Article |
| id | doaj.art-e2d130d3ac08458c950ae76d45e7a854 |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-21T05:39:21Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-e2d130d3ac08458c950ae76d45e7a8542022-12-21T19:14:19ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922020-01-012013940Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism?Krishna Kumar Mohanan Nair0Narayanan Namboodiri1Sreevilasam Pushpangadhan Abhilash2Mukund Prabhu3Debasish Das4Ajitkumar Valaparambil5Corresponding author.; Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, IndiaDepartment of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, IndiaDepartment of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, IndiaDepartment of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, IndiaDepartment of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, IndiaDepartment of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India33 year old gentleman has undergone an electrophysiology study for recurrent paroxysmal palpitation. During one of the episodes of palpitation a regular narrow QRS tachycardia was documented which has terminated with intravenous adenosine. Baseline electrocardiogram did not show any pre-excitation. Atrial-His (AH) and His-Ventricular (HV) intervals were normal at baseline. There was no evidence of dual atrioventricular (AV) nodal physiology. Earliest atrial electrogram during ventricular pacing was recorded at coronary sinus (CS) 9,10 dipoles placed at CS OS region. Narrow QRS tachycardia with cycle length (TCL) of 400 ms and earliest retrograde atrial activation at CS 9,10 dipoles was induced with programmed ventricular stimulation. Ventricular overdrive (VOD) pacing was performed at 30 ms shorter than TCL during the tachycardia (Fig: 1). What is the mechanism of tachycardia? Keywords: Entrainment, Orthodromic his capture, AV reentry, Narrow QRS tachycardiahttp://www.sciencedirect.com/science/article/pii/S0972629219301421 |
| spellingShingle | Krishna Kumar Mohanan Nair Narayanan Namboodiri Sreevilasam Pushpangadhan Abhilash Mukund Prabhu Debasish Das Ajitkumar Valaparambil Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism? Indian Pacing and Electrophysiology Journal |
| title | Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism? |
| title_full | Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism? |
| title_fullStr | Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism? |
| title_full_unstemmed | Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism? |
| title_short | Interesting response to ventricular overdrive pacing during regular narrow QRS tachycardia. What is the mechanism? |
| title_sort | interesting response to ventricular overdrive pacing during regular narrow qrs tachycardia what is the mechanism |
| url | http://www.sciencedirect.com/science/article/pii/S0972629219301421 |
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