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July 10, 2026Open Access

Sequential radiofrequency ablation successfully terminates atypical and typical AVNRTs located 6 mm apart.

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Population

A 72-year-old woman with long-standing palpitations and narrow-QRS SVT

Design

Case report

Key result

Sequential radiofrequency ablation successfully terminated atypical fast-slow AVNRT and a second typical slow-fast AVNRT located 6 mm away, resulting in noninducibility.

Authors

LMLuis Enrique Godínez MuñozHCHugo Elorreaga CamachoJNJorge Alberto Loza Nuno

Discussion

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Overview

May guide individualized ablation in complex elderly AVNRT cases; leaves open generalizability pending larger prospective data.

Key Points

  • This case aims to demonstrate the successful sequential ablation of fast-slow and slow-fast AVNRT mechanisms in a single patient.
  • Electrophysiological evaluation performed with a 12-lead electrocardiogram and transthoracic echocardiography to exclude structural heart disease.
  • Radiofrequency ablation targeted close to the coronary sinus ostium to terminate tachycardia and evaluate for coexisting tachycardia.
  • Atrial stimulation conducted to identify a second tachycardia and facilitate subsequent targeted ablation.
  • First ablation terminated atypical fast-slow AVNRT without complications.
  • Second tachycardia was induced with a cycle length of 430 ms and treated successfully with a second ablation site 6 mm from the first.
  • Both ablation procedures resulted in noninducibility of the arrhythmias with preserved AV conduction.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 72-year-old woman with symptomatic, drug-refractory palpitations due to coexisting fast-slow and slow-fast AVNRT.
I
Intervention
Sequential radiofrequency ablation (initial ablation close to the coronary sinus ostium, followed by a second target 6 mm from the initial site).
O
Outcome
Termination of tachycardia and noninducibility without atrioventricular conduction compromise.

This case illustrates the successful use of individualized sequential radiofrequency ablation for coexisting atypical fast-slow and typical slow-fast AVNRT.

Cite This Study

Muñoz et al. (2026) conducted a case report in Atrioventricular nodal reentrant tachycardia (AVNRT) (n=1). Sequential radiofrequency ablation was evaluated on Termination of tachycardia and noninducibility. Sequential radiofrequency ablation successfully terminated atypical fast-slow AVNRT and a second typical slow-fast AVNRT located 6 mm away, resulting in noninducibility.

synapsesocial.com/papers/6a508cc46eeac72a437a0aechttps://doi.org/10.5281/zenodo.21257610
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Beyond the Classical Approach: Successful Sequential Ablation of Fast-Slow and Slow-Fast Atrioventricular Nodal Reentrant Tachycardia. An Illustrative Case2026
  2. 2Slow Atrioventricular Nodal Reentrant Arrhythmias: Clinical Recognition, Electrophysiological Characteristics, and Response to Radiofrequency Ablation2007 · 11 citations
  3. 3Successful Ablation of Atypical Atrioventricular Nodal Reentrant Tachycardia From a Noncoronary Sinus of Valsalva2014 · 11 citations
  4. 4Fast–slow atrioventricular nodal re‐entrant tachycardia incorporating superior and inferolateral left atrial slow pathways2023 · 3 citations
  5. 5Fast-slow Atrioventricular Nodal Reentrant Tachycardia Incorporating Superior and Inferolateral Left Atrial Slow Pathways2023 · 1 citations