Key result
A patient with 'triple-fire' atrioventricular non-reentrant tachycardia demonstrated three distinct atrioventricular nodal pathways and multiple triple fire responses on ECG and electrograms.
Case Report (n=1)
This case report describes a rare instance of 'triple-fire' atrioventricular non-reentrant tachycardia, highlighting the clinical ramifications of multiple pathways physiology.
Triple AV nodal pathways merit consideration in refractory tachycardias; leaves open prevalence and ablation strategies.
INTRODUCTION: Although uncommonly encountered, dual atrioventricular nodal non-reentrant tachycardia (DAVNNRT) is a well-described arrhythmia that can manifest in patients with dual atrioventricular nodal pathways physiology. This arrhythmia is characterized on electrocardiogram (ECG) by a single P wave followed by two conducted QRS complexes (so-called "double fire"), and on intracardiac electrograms by a single atrial electrogram followed by two separate His deflections and ventricular electrograms. METHODS/RESULTS: We report a rare case of "triple-fire" atrioventricular non-reentrant tachycardia in which a patient was found to have three distinct atrioventricular nodal pathways and multiple triple fire responses, both on surface ECG and intracardiac electrograms. CONCLUSION: Multiple pathways physiology and it's clinical ramifications are discussed.
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Raphael et al. (2022) conducted a case report in Atrioventricular non-reentrant tachycardia (n=1). A patient with 'triple-fire' atrioventricular non-reentrant tachycardia demonstrated three distinct atrioventricular nodal pathways and multiple triple fire responses on ECG and electrograms.
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