Reproducible induction of atrioventricular nodal reentrant tachycardia with adenosine triphosphate

A 29-year-old woman was referred for electrophysiological testing and radiofrequency ablation because of repeated episodes of palpitation of a 8-year duration. The 12-lead ECG during palpitations showed narrow QRS tachycardia at a rate of 160 beats/min. Dual AVN physiology according to electrophysiological criteria was not shown by single atrial extrastimulation and the tachycardia could not be induced. Slow/fast atrioventricular nodal reentrant tachycardia (AVNRT) was induced once by double atrial extrastimuli, but it was not reproducible. However, intravenous bolus injection of adenosine triphosphate (12.5 mg) during sinus rhythm led to reproducible initiation of slow/fast AVNRT.