A Case of Successful Catheter Ablation for Paroxysmal Supraventricular Tachycardia with Two Alternating Cycle Lengths

Masanari Asai; Masayoshi Kiyokuni; Kazuho Ishii; Yuuna Kine; Yu Yamada; Hiroyuki Ishikawa; Shintaro Koga; Shunsuke Kataoka; Katsutaka Hashiba; Tatsuya Nakachi; Tsutomu Endo

doi:10.2169/internalmedicine.1491-22

This article has now been updated. Please use the final version.

A Case of Successful Catheter Ablation for Paroxysmal Supraventricular Tachycardia with Two Alternating Cycle Lengths

Masanari Asai, Masayoshi Kiyokuni, Kazuho Ishii, Yuuna Kine, Yu Yamada, Hiroyuki Ishikawa, Shintaro Koga, Shunsuke Kataoka, Katsutaka Hashiba, Tatsuya Nakachi, Tsutomu Endo

Author information

Masanari Asai
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Masayoshi Kiyokuni
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Kazuho Ishii
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Yuuna Kine
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Yu Yamada
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Hiroyuki Ishikawa
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Shintaro Koga
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Shunsuke Kataoka
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Katsutaka Hashiba
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Tatsuya Nakachi
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan
Tsutomu Endo
Department of Cardiology, Saiseikai Yokohamashi Nanbu Hospital, Japan

Keywords: paroxysmal supraventricular tachycardia, regularly irregular narrow QRS tachycardia, accessory pathway, dual atrioventricular nodal pathway

JOURNAL OPEN ACCESS Advance online publication

Article ID: 1491-22

DOI https://doi.org/10.2169/internalmedicine.1491-22

The final version of this article is now available: Vol. 63 (2024), No. 1 pp. 93-96

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Abstract

A 62-year-old male was transferred to our hospital complaining of palpitations. His heart rate was 185/min. Electrocardiogram showed a narrow QRS regular tachycardia and the tachycardia changed spontaneously to another narrow QRS tachycardia with two alternating cycle lengths. The arrhythmia was stopped by the administration of adenosine triphosphate. Findings from electrophysiological study suggested that there was an accessory pathway (AP) and dual atrioventricular (AV) nodal pathways. After AP ablation, any other tachyarrythmias were not induced. We supposed that the tachycardia was paroxysmal supraventricular tachycardia involving AP and anterograde conduction alternating between slow and fast AV nodal pathways.

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