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KMID : 1011920110120020045
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International Journal of Arrhythmia
2011 Volume.12 No. 2 p.45 ~ p.49
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A case of paroxysmal antidromic atrioventricular reentrant tachycardia with AF
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On Young-Keun
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Abstract
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In the Wolff-Parkinson-White (WPW) syndrome, atrioventricular (AV) conduction occurs through an AV bypass tract, which results in earlier activation (preexcitation) of the ventricles. Antidromic atrioventricular reentrant tachycardia (AVRT) is characterized by a wide QRS complex and ventricular rates of up to 250 beats/min. The width of the preexcited QRS complex and the amplitude of the ST-T wave segment usually obscure the retrograde P wave on the surface ECG. The rhythm of preexcited atrial fibrillation (AF) is exceptionally irregular, and can be associated with very rapid ventricular responses caused by the nondecremental anterograde AV conduction over the bypass tract. A shortest preexcited RR interval of less than 250 milliseconds during sustained AF is a very sensitive marker of the risk of VF in WPW syndrome. Catheter ablation is considered first-line therapy for patients with WPW syndrome.
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KEYWORD
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Wolff-Parkinson-White (WPW) syndrome, antidromic atrioventricular reentrant tachycardia (AVRT) , catheter ablation
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