What question did this study set out to answer?

To determine the electrophysiological mechanism underlying an adenosine-sensitive narrow QRS tachycardia in a patient evaluated for radiofrequency catheter ablation.

August 1, 2021Journal of Innovations in Cardiac Rhythm ManagementOpen Access

Narrow QRS Tachycardia: What Is the Mechanism?

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Why the study?

What is the mechanism of narrow QRS tachycardia in this patient?

Key Points

To determine the electrophysiological mechanism underlying an adenosine-sensitive narrow QRS tachycardia in a patient evaluated for radiofrequency catheter ablation.
Assessed baseline cardiac structure and conduction with 12-lead electrocardiography and transthoracic echocardiography in a 45-year-old man.
Performed an invasive electrophysiological study measuring baseline conduction intervals (atrial-His and His-ventricular intervals) and testing for dual atrioventricular nodal physiology.
Executed programmed atrial pacing protocols to induce and characterize the tachycardia.
Baseline electrophysiological evaluation revealed normal sinus rhythm conduction intervals (atrial-His interval of 110 ms, His-ventricular interval of 44 ms) without pre-excitation or dual AV nodal physiology.
Programmed atrial pacing protocols easily and reproducibly triggered the narrow QRS tachycardia, which had previously terminated following intravenous adenosine administration.

Structured PICO

What is the mechanism of narrow QRS tachycardia in this patient?

Population

45-year-old man with narrow QRS tachycardia

Intervention

Electrophysiological study and radiofrequency catheter ablation

Outcome

Mechanism of the tachycardia

This case presents an electrophysiological study of a narrow QRS tachycardia to determine its underlying mechanism.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May inform ablation strategies in rare adenosine-sensitive tachycardias; leaves open confirmation in larger series.

Cite This Study

NAIR et al. (2021) studied this question.

synapsesocial.com/papers/6a72cb7bce524a4339c59587 https://doi.org/10.19102/icrm.2021.120803

View Full Paper

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Narrow QRS Tachycardia: What Is the Mechanism?

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Narrow QRS Tachycardia: What Is the Mechanism?

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider