Longitudinal Dissociation in the His Bundle: A Possible Mechanism of Two Distinct Cycle Lengths in Atrioventricular Reentrant Tachycardia |
| |
| Authors: | JUNICHI AKIYAMA KAZUTAKA AONUMA SHIGEKO OGAHARA YOSHIHIRO OKAMOTO SHIGEO UMEZAWA MIHOE INADA MASAYOSHI KORENAGA AKIHIKO NOGAMI MICHIAKI HIROE FUMIAKI MARUMO YOSHITO IESAKA |
| |
| Affiliation: | Department of Cardiology, Yokosuka Kyosai Ceneral Hospital, Japan;Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan;Department of Cardiology, Tsuchiura Kyodo Ceneral Hospital, Japan |
| |
| Abstract: | Two wide QRS tachycardias with identical morphology but different cycle lengths (CLs) developed in a 63-year-old man. Electrophysiological study demonstrated inducible atrioventricular reentrant tachycardia (AVRT) due to a concealed left posterior accessory pathway (AP), which was successfully ablated by radiofrequency application. Neither dual AV nodal pathways nor other APs were documented. Splitting of the His-bundle electrogram was shown, and programmed stimulation induced sudden prolongation of intra-hisian conduction time. These results suggest longitudinal dissociation in the His bundle may be responsible for two distinct CLs in AVRT without dualAV nodal physiology. |
| |
| Keywords: | longitudinal dissociation supraventricular tachycardia His bundle |
|
