de la Vega VK, Dorantes SM, Fernández VL, de la Vega GR, Castaṅeda CO, Martínez LF, Falcón RR

Language: Spanish
References: 4
Page: 389-392
PDF size: 1248.79 Kb.

ABSTRACT

We present a 44-year-old female patient with two types of tachycardia QRS com-plexes), symptomatic, with different pathophysiological mechanisms. The narrow one, incessant, with RP greater than the PR, as well as negative P wave in II, III and aVF leads; which began at an early age and had three possible diagnoses: accessory pathway with decremental conduction, inverted atrioventricular nodal reentrant tachycardia, or atrial tachycardia. The latter was demonstrated by electrical stimu-lation. She presented a single episode of wide QRS complex tachycardia with ante-grade conduction through the left lateral accessory pathway, with maximum preex-citation (a variety not evident in sinus rhythm, since there were never signs of ven-tricular preexcitation, only present during the tachycardia). Both arrhythmias were successfully solved with radiofrequency ablation, although late. It is important to reach an accurate diagnosis promptly in these symptomatic arrhythmias of long evolution, incessant and refractory to treatment, to avoid possible complications such as tachycardiomyopathy and other malignant arrhythmias (antidromic tachy-cardia in this case), for their early solution.

REFERENCES

1. Vijayaraman P, Alaeddini J, Storm R, Oren J, Wood MA, Ellenbogen KA. Slow atrioventricular nodal reentrant arrhythmias: clinical recognition, elec-trophysiological characteristics, and response to radiofrequency ablation. J Cardiovasc Electro-physiol. 2007;18(9):950-3. [DOI]

2. Dorantes Sánchez M, Cruz Cardentey M, Arias Ota-mendy Y, Castro Hevia JA, Castañeda Chirino O. Taquicardia por reentrada intranodal: Singularida-des - Ladder diagram y una historia de 135 años. CorSalud [Internet]. 2021 [citado 10 Jul 2022];13(2): 211-6. Disponible en: https://revcorsalud.sld.cu/in-dex.php/cors/article/view/851/1393

3. Pappone C, Vicedomini G, Manguso F, Saviano M, Baldi M, Pappone A, et al. Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation. 2014;130(10):811-9. [DOI]

4. Yagishita A, Hachiya H, Higuchi K, Nakamura T, Sugiyama K, Tanaka Y, et al. Differentiation of atrial tachycardia from other long RP tachycardias by electrocardiographic characteristics. J Arrhythm. 2014;30(5):376-81. [DOI]