Article thumbnail

Multiple Arrhythmogenic Substrate for Tachycardia in a Patient with Frequent Palpitations

By Majid Haghjoo, Arash Arya, Mohammadreza Dehghani, Zahra Emkanjoo, Amirfarjam Fazelifar and MohammadAli Sadr-Ameli


We report a 26-year-old woman with frequent episodes of palpitation and dizziness. Resting electrocardiography showed no evidence of ventricular preexcitation. During electrophysiologic study, a concealed right posteroseptal accessory pathway was detected and orthodromic atrioventricular reentrant tachycardia incorporating this pathway as a retrograde limb was reproducibly induced. After successful ablation of right posteroseptal accessory pathway, another tachycardia was induced using a concealed right posterolateral accessory pathway in tachycardia circuit. After loss of retrograde conduction of second accessory pathway with radiofrequency ablation, dual atrioventricular nodal physiology was detected and typical atrioventricular nodal reentrant tachycardia was repeatedly induced. Slow pathway ablation was done successfully. Finally sustained self-terminating atrial tachycardia was induced under isoproterenol infusion but no attempt was made for ablation. During 8-month follow-up, no recurrence of symptoms attributable to tachycardia was observed

Topics: Indian Pacing and Electrophysiology Journal
Publisher: Indian Pacing and Electrophysiology Group
Year: 2005
OAI identifier:

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2005). Adulterous Tachycardia: What Is the Mechanism? PACE 1998;21:1146-7. doi
  2. (1990). Atrioventricular nodal reentry and dual atrioventricular node physiology in patients undergoing accessory pathway ablation.
  3. Dual atrioventricular nodal pathways in patients with Wolf-Parkinson-White syndrome. doi
  4. (1995). Effects of dual atrioventricular node pathways on atrioventricular reentrant tachycardia. Circulation doi
  5. Incidence and clinical significance of inducible atrial tachycardia in patients with atrioventricular nodal reentrant tachycardia.
  6. Multiple accessory pathways in patients with the preexcitation syndrome.
  7. Preexcitation syndromes. In:
  8. (1994). Radiofrequency ablation in a patient with tachycardia incorporating triple free wall accessory pathways and atrioventricular nodal reentrant tachycardia.
  9. Radiofrequency ablation in two patients with typical and atypical atrioventricular nodal reentrant tachycardias, associated with atrioventricular reentrant tachycardias.
  10. Radiofrequency ablation of multiple accessory pathways.
  11. Radiofrequency catheter ablation for a patient with Wolf-Parkinsin-White syndrome associated with sustained atrial tachycardia.
  12. (1994). Radiofrequency catheter ablation of both atrial ventricular nodal reentrant and atrial ventricular reentrant tachycardia in a single session. Clin Cardiol
  13. (1978). the preexcitation syndromes. Frog Cardiovasc Dis