Key result
Ablation resolves rare wide QRS tachycardia involving atrial flutter, accessory pathway, and dual AV nodal pathways.
Why the study?
Some atrial flutter cases may present with accessory pathways and dual atrioventricular node pathways, complicating diagnosis and treatment strategies.
Case Report (n=1)
This case highlights the importance of electrophysiological examination in diagnosing and treating complex arrhythmias presenting as wide QRS complex tachycardia.
May inform EP evaluation of rare wide QRS tachycardia; leaves open generalizability beyond this single case.
Key Clinical Message: Atrial flutter (AFL) and supraventricular tachycardia (SVT) are common arrhythmias in clinic. However, some AFL cases may present additional complexities, such as both accessory pathways (AP) and dual atrioventricular node pathways, putting on a mysterious mask and making it challenging to distinguish on electrocardiograms (ECGs). Abstract: A 60-year-old male patient had a sudden syncope, and an ECG showed wide QRS complex tachycardia. This diagnostic ambiguity is further compounded by the fact that SVT via AP conduction can exhibit wide QRS complex tachycardia characteristics resembling ventricular tachycardia (VT). Consequently, a definitive diagnosis through electrophysiological (EP) examination becomes imperative, as it dictates subsequent ablation strategies. In this article, we present a rare case involving three distinct arrhythmias including AFL, AP, and dual atrioventricular node pathways, and successfully treated through ablation.
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Liu et al. (2023) conducted a case report in Wide QRS complex tachycardia (Atrial flutter, accessory pathway, and dual atrioventricular node pathways) (n=1). Ablation was evaluated on Successful treatment of arrhythmias. Ablation successfully treated a rare presentation of wide QRS complex tachycardia involving atrial flutter, an accessory pathway, and dual atrioventricular node pathways.
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