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Spontaneous Deterioration of Atrioventricular Nodal Reentrant Tachycardia to Polymorphic Ventricular Tachycardia in the Absence of Heart Disease
Author(s) -
MOONDRA VAIBHAV,
SANGHA RAJBIR,
GREENBERG MARK L.
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2010.02737.x
Subject(s) - medicine , cardiology , tachycardia , nodal , heart disease , ventricular tachycardia
Atrioventricular nodal reentrant tachycardia (AVNRT) is usually associated with a good prognosis. This is a case of a 57‐year woman who presented with supraventricular tachycardia that spontaneously deteriorated to polymorphic ventricular tachycardia (PVT). The PVT terminated without treatment after 16 seconds. Extensive cardiac evaluation including echocardiography, stress testing, coronary angiography, and cardiac magnetic resonance imaging did not reveal any structural heart disease. Electrophysiology testing demonstrated typical AVNRT which was successfully treated with cryoablation. The clinical ventricular tachycardia could not be reproduced despite the use of an aggressive induction protocol and isoproterenol. Postablation, exercise treadmill testing did not provoke any tachyarrhythmia. The patient is doing well 13 months later. In summary, we present the rare finding of a moderately fast, typical AVNRT degenerating to a long run of PVT, in the absence of any detectable heart disease or other etiology for PVT. (PACE 2011; 34:e14–e17)