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A supraventricular tachycardia with the atrial interval variability: What is the mechanism?
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  • Atsushi Doi,
  • Kazuya Sugioka,
  • Takuya Tsukamoto,
  • Sawa Tanaka,
  • Naoko Takaoka,
  • Toshiharu Iwamura,
  • Takahiko Kawarabayashi,
  • Daiju Fukuda
Atsushi Doi
Tane Sogo Byoin

Corresponding Author:[email protected]

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Kazuya Sugioka
Tane Sogo Byoin
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Takuya Tsukamoto
Tane Sogo Byoin
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Sawa Tanaka
Tane Sogo Byoin
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Naoko Takaoka
Tane Sogo Byoin
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Toshiharu Iwamura
Tane Sogo Byoin
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Takahiko Kawarabayashi
Tane Sogo Byoin
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Daiju Fukuda
Osaka Koritsu Daigaku Igakubu Fuzoku Byoin
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Abstract

not-yet-known not-yet-known not-yet-known unknown A 57-year-old woman with frequent palpitations was referred for radiofrequency ablation. The baseline 12-lead electrocardiogram and echocardiography were normal. The baseline atrio-His (AH) and His-ventricular (HV) intervals were 70 and 35 ms, respectively. Dual atrioventricular (AV) nodal physiology was not observed during programmed atrial stimulation. Ventriculoatrial conduction showed a decremental and concentric pattern, with the earliest atrial activation recorded in the His bundle region. There was no evidence of a jump-up phenomenon during programmed ventricular stimulation. Supraventricular tachycardia (SVT) with variable AH and His-atrial (HA) intervals was induced by extra atrial stimulation without any jump-up in the AH interval. The earliest atrial activation during SVT was recorded at the coronary sinus (CS) 7,8 region, corresponding to the CS ostium, which differed from the atrial activation sequence during ventricular pacing. The atrial-atrial (AA) intervals demonstrated variability exceeding 50 ms without any alteration in the atrial activation sequence (Figure 1A). Ventricular entrainment pacing was performed during SVT (Figure 1B). Transient 2:1 AV conduction was observed during SVT (Figure 1C). Based on these findings, what is the mechanism of the variability in the AA, AH, and HA intervals during tachycardia?
22 Nov 2024Submitted to Journal of Cardiovascular Electrophysiology
23 Nov 2024Submission Checks Completed
23 Nov 2024Assigned to Editor
23 Nov 2024Review(s) Completed, Editorial Evaluation Pending
24 Nov 2024Reviewer(s) Assigned