Key result
Successful slow pathway ablation resolved AVNRT in a patient whose incongruous para-Hisian entrainment response was caused by direct His-bundle capture.
Why the study?
Interpretation of para-Hisian entrainment during SVT can yield contradictory results due to unusual responses such as direct His-bundle capture.
Case Report (n=1)
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This case highlights the importance of correctly interpreting para-Hisian entrainment and recognizing direct His-bundle capture to avoid misdiagnosing AVNRT as AVRT.
50 years old lady presented with paroxysmal palpitation for the last 5 years. During electrophysiological study A -on-V tachycardia was induced by atrial and ventricular pacing. HA and AH interval during tachycardia were suggesting the diagnosis of typical slow-fast atrioventricular nodal re-entrant tachycardia (AVNRT). The response of para-Hisian entrainment and his refractory premature ventricular complex during tachycardia was in favour of atrioventricular re-entrant tachycardia instead of typical slow-fast AVNRT .This incongruous response was attributed to the direct His-bundle capture while doing the above maneuvers. This patient underwent successful ablation of slow pathway. This case highlights the importance of interpretation of para-Hisian entrainment to avoid contradictory results
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Halder et al. (2026) conducted a case report in Paroxysmal supraventricular tachycardia (AVNRT) (n=1). Electrophysiological study and slow pathway ablation was evaluated on Successful ablation of slow pathway. Successful slow pathway ablation resolved AVNRT in a patient whose incongruous para-Hisian entrainment response was caused by direct His-bundle capture.
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