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A Long RP Tachycardia: What is the Tachycardia Mechanism?
Author(s) -
STICHERLING CHRISTIAN,
KNIGHT BRADLEY P.
Publication year - 2001
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2001.00115.x
Subject(s) - medicine , knight , tachycardia , center (category theory) , chemistry , physics , astronomy , crystallography
A 75-year-old man underwent an electrophysiologic procedure because of recurrent palpitations and documented tachycardia. At baseline, there was sinus rhythm with right bundle branch block. Programmed stimulation demonstrated anterograde dual AV nodal physiology. A regular, long RP tachycardia with a cycle length of 540 msec and inverted P waves in the inferior leads was induced by atrial overdrive pacing (Fig. 1). The QRS morphology and His-ventricular interval were identical during sinus rhythm and during tachycardia. Ventricular pacing at a cycle length of 520 msec during tachycardia accelerated the atrial cycle length to the pacing cycle length. The response upon cessation of pacing is shown in Figure 2. After infusion of isoproterenol, typical AV nodal reentrant tachycardia was induced. During slow pathway ablation, inadvertent temporary complete AV block occurred (Fig. 3). What is the mechanism of the long RP tachycardia?