Open AccessAntidromic atrioventricular reentrant tachycardia mimicking ventricular tachycardia in the setting of previous myocardial infarction
Author(s) -
Dagres Nikolaos,
Clague Jonathan R.,
Kottkamp Hans,
Breithardt Günter,
Borggrefe Martin
Publication year - 2000
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960230122
Subject(s) - medicine , cardiology , tachycardia , atrioventricular reentrant tachycardia , myocardial infarction , reentry , ventricular tachycardia , antidromic , supraventricular tachycardia , coronary artery disease , qrs complex , anesthesia , accessory pathway , atrial fibrillation , catheter ablation , electrophysiology
The differentiation between ventricular tachycardia and broad‐complex supraventricular tachycardia can be extremely difficult, particularly in emergency situations. We report a case of hemodynamically compromising broad‐complex tachycardia in a 63‐year‐old man. The patient had previously sustained an anteroseptal myocardial infarction and had subsequently undergone coronary artery bypass surgery because of triple‐vessel coronary artery disease. Intravenous treatment with ajmalin terminated the tachycardia and revealed preexcited QRS complexes compatible with the presence of a left‐sided atrioventricular accessory pathway. An antidromic atrioventricular reentrant tachycardia (identical to the clinical tachycardia) was induced during an electrophysiologic study. In conclusion, there are several causes of broad‐complex tachycardia, even in patients with previous myocardial infarction, and, where doubt exists, electrophysiologic studies should be performed.