Key result
Left accessory pathway ablation resolves AVRT-induced electrical and mechanical alternans, maintaining zero recurrence through 8 years.
Why the study?
Pulsus alternans is typically linked to severe heart disease and rarely reported in healthy individuals.
Case Report (n=1)
This case demonstrates that acute 2:1 pulsus and electrical alternans can rarely occur during AVRT in a structurally normal heart and is curable with ablation.
Rare alternans in AVRT may prompt ablation consideration; single case leaves generalizability open.
Pulsus alternans (PA) is a hemodynamic phenomenon characterized by a beat-to-beat alternation in pulse amplitude that results in a clinically appreciable pulse rate half of the electrical rate. It was first described in 1872 by Traube1 and many theories have been postulated regarding its pathophysiology. PA is usually associated with severe heart disease and can eventually result in pulseless electrical activity.2–4 It has rarely been described in healthy individuals. In contrast, electrical alternans (EA) is defined by alternating QRS amplitudes on an electrocardiogram.
No takes yet. Share an insight, caveat, or question.
Martini et al. (2021) conducted a case report in Atrioventricular reciprocating tachycardia with pulsus and electrical alternans (n=1). Ablation of left accessory pathway was evaluated on Symptom recurrence and biventricular function. Ablation of a left accessory pathway successfully treated a rare case of acute 2:1 pulsus and electrical alternans during atrioventricular reciprocating tachycardia, with no recurrence over 8 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: