Why the study?
While AVNRT and AVRT are both commonly found in patients, their concomitant occurrence and transitions between the two supraventricular tachycardias are rare.
Case Report (n=1)
No
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This case demonstrates that rare coexisting AVNRT and orthodromic AVRT with spontaneous transition in a pediatric patient can be successfully identified and cured via comprehensive electrophysiological mapping and radiofrequency ablation of both pathways.
Case RepoRt DiscussionSupraventricular tachycardia has a prevalence of 2.25/1,000 persons and an incidence of 35/100,000 person-years.1,2 Both AVNRT and AVRT are commonly found in patients, but concomitant occurrence is rare.3,4 Some authors reported complete cure by ablating the common pathway limb of both tachycardias.5,6 Kondo et al. described a case of Wolff-Parkinson-White (WPW) syndrome with spontaneous mutual frequent transition between AVRT and AVNRT, noting that while unidirectional transition had been previously reported, bidirectional transition was novel.7 Jen-Yuan Kuo et al. described mechanisms of transition between two supraventricular tachycardias.3 Transition between two tachycardias occurred due to a spontaneous premature atrial complex (30%), conduction block at one limb of tachycardia (20%), or tachycardia-induced tachycardia (50%).Absence of transition
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Karandikar et al. (2026) conducted a case report in Coexisting atrioventricular nodal reentrant tachycardia (AVNRT) and orthodromic atrioventricular reentrant tachycardia (AVRT) (n=1). Radiofrequency catheter ablation of the AV nodal slow pathway and right-sided lateral accessory pathway was evaluated on Non-inducibility of AVNRT and AVRT at baseline and after isoprenaline infusion.
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