Key result
Understanding the pattern of termination of supraventricular tachycardia, such as resolution of ipsilateral bundle branch block, can demonstrate the participation of an accessory pathway.
Case Report
Understanding the pattern of termination of supraventricular tachycardia, such as with the resolution of bundle branch block, is crucial for making a precise diagnosis of the underlying arrhythmia mechanism.
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May aid SVT mechanism diagnosis via termination patterns; hypothesis-generating, should not yet change practice.
Key Teaching Points•The presence of an accessory pathway and the participation of the pathway in supraventricular tachycardia can be demonstrated by a prolongation of the retrograde ventriculoatrial time with ipsilateral bundle branch block and termination of the tachycardia with resolution of bundle branch block.•Eccentric ventriculoatrial activation during tachycardia can be seen with a left-sided accessory pathway, atrioventricular nodal reentrant tachycardia due to a left posterior extension of the atrioventricular node, or atrial tachycardia.•Understanding the pattern of termination of supraventricular tachycardia can make a precise diagnosis. •The presence of an accessory pathway and the participation of the pathway in supraventricular tachycardia can be demonstrated by a prolongation of the retrograde ventriculoatrial time with ipsilateral bundle branch block and termination of the tachycardia with resolution of bundle branch block.•Eccentric ventriculoatrial activation during tachycardia can be seen with a left-sided accessory pathway, atrioventricular nodal reentrant tachycardia due to a left posterior extension of the atrioventricular node, or atrial tachycardia.•Understanding the pattern of termination of supraventricular tachycardia can make a precise diagnosis.
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Oesterle et al. (2018) conducted a case report in Supraventricular tachycardia with left bundle branch block. Understanding the pattern of termination of supraventricular tachycardia, such as resolution of ipsilateral bundle branch block, can demonstrate the participation of an accessory pathway.
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