This case demonstrates that AV nodal reentrant tachycardia with persistent ventriculoatrial block can be successfully treated with a typical posteroseptal ablation approach.
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May allow posteroseptal ablation in AVNRT with VA block; leaves generalizability open pending further cases.
We report the case of a 64-year-old patient with paroxysmal supraventricular tachycardia and persistent VA block. Induction and maintenance of tachycardia occurred without apparent activation of the atria. Diagnostic characteristics were most compatible with AV nodal reentrant tachycardia (AVNRT). Automatic junctional tachycardia and orthodromic nodoventricular or nodofascicular reentry tachycardia were considered in the differential diagnosis. Upper common pathway block during AVNRT may be explained by either intra-atrial conduction block or purely intranodal confined AVNRT. The arrhythmia was cured by a typical posteroseptal ablation approach guided by slow pathway potentials.
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Strohmer et al. (2003) studied this question.
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