Key result
An atypical presentation of AV nodal reentry tachycardia with ventriculoatrial dissociation occurred early after aortic valve replacement, suggesting a strictly nodal circuit location.
Case Report (n=1)
No
AV nodal reentry should be considered as a mechanism for wide QRS tachycardia in the early postoperative period following aortic valve replacement.
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AVNRT with VA dissociation merits inclusion in the post-AVR wide-complex tachycardia differential; this case leaves open its true incidence and generalizability.
We report an atypical presentation of atrioventricular (AV) nodal reentry tachycardia with periods of ventriculoatrial Wenckebach and complete ventriculoatrial dissociation which appeared in a male patient in the postoperative period following aortic valve replacement and plication of Valsalva's posterior sinus. The context for the onset of this AV nodal reentry tachycardia and the concurrent electrophysiological findings support the hypothesis of a strictly nodal location of the circuit and suggest that the electrical modifications sustained by the perinodal region are the triggering agent for the reentry mechanism. Therefore, the AV nodal reentry is a mechanism that must be considered when tachycardia appears in the early postoperative period following aortic valve replacement.
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Palanca et al. (2007) conducted a case report in Atrioventricular nodal reentry tachycardia (n=1). An atypical presentation of AV nodal reentry tachycardia with ventriculoatrial dissociation occurred early after aortic valve replacement, suggesting a strictly nodal circuit location.
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