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Atypical twin atrioventricular nodal re-entrant tachycardia in a congenitally corrected transposition of the great arteries patient with a surgical repair of a ventricular septal defect: a case report. | LitMetric

Atypical twin atrioventricular nodal re-entrant tachycardia in a congenitally corrected transposition of the great arteries patient with a surgical repair of a ventricular septal defect: a case report.

Eur Heart J Case Rep

Electrophysiologie et stimulation cardiaque, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 28 avenue du Doyen Lepine, 69500 Bron France For the podcast associated with this article, please visit https://academic.oup.com/ehjcr/pages/podcast.

Published: August 2021

AI Article Synopsis

  • Twin atrioventricular (AV) nodal tachycardia is a rare type of heart rhythm issue seen in some congenital heart defects, involving two distinct AV nodes that can create different QRS patterns in sinus rhythm.
  • A case involving a 15-year-old patient with congenitally corrected transposition of the great arteries showed that previous heart surgery affected the normal conduction in the inferior AV node, leading to a unique heart rhythm and requiring catheter ablation for treatment.
  • This condition is uncommon and can present atypically due to prior surgeries, highlighting the need for medical professionals to recognize associated congenital heart defects in managing such tachycardias.

Article Abstract

Background: Twin atrioventricular (AV) nodal tachycardia is a rare mechanism of supraventricular arrhythmia, only seen in some specific congenital heart defects (CHD). It consists of a re-entrant circuit between two distinct AV nodes (anterior and inferior). Since both nodes have antegrade and retrograde conduction, there is usually two QRS morphologies in sinus rhythm.

Case Summary: This case is about an atypical twin AV nodal tachycardia in a 15 years old patient with congenitally corrected transposition of the great arteries and previous history of a ventricular septal defect repair. The surgical closure was probably responsible of a poor antegrade conduction over the inferior AV node, which was responsible for a unique QRS morphology. He finally received a catheter ablation of the inferior AV node. He remained asymptomatic without anti-arrhythmic drugs at 8-months post-ablation.

Discussion: Twin AV nodal re-entrant tachycardia is a rare phenomenon. The presentation and electrophysiological study can be both atypical due to previous surgical repair. The operator should be aware of specific CHD where twin AV nodal re-entrant tachycardias are expected.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350359PMC
http://dx.doi.org/10.1093/ehjcr/ytab303DOI Listing

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