Document Detail

Ischemic etiology for adenosine-sensitive fascicular tachycardia.
MedLine Citation:
PMID:  20832812     Owner:  NLM     Status:  MEDLINE    
Adenosine-responsive ventricular tachycardias (VTs) typically occur in patients without structural heart disease; and thus, its association with myocardial ischemia is rare. In this case report, we describe a patient who had demonstrable ischemia along the anterolateral wall of the left ventricle and who developed a VT that was clinically terminated with adenosine. Surface electrocardiogram demonstrated a monomorphic VT with a right bundle-branch block morphology and a rightward axis configuration, and electrophysiologic testing showed atrioventricular dissociation upon atrial pacing and retrograde His waves following induction of VT. These findings localized the patient's VT to the left anterior fascicle, an anatomical region that coincided with the patient's territory of ischemia. We describe the electrophysiologic testing involved in elucidating the patient's tachyarrhythmia, and we provide a brief discussion of the pathogenesis and clinical features of adenosine-sensitive VT. Our case demonstrates that heterogeneous mechanisms of VT are operative in patients with ischemic heart disease.
Daniel Jane-Wit; William Batsford; Brian Malm
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-09-15
Journal Detail:
Title:  Journal of electrocardiology     Volume:  44     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-02-28     Completed Date:  2011-07-13     Revised Date:  2014-04-29    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  217-21     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
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MeSH Terms
Adenosine / diagnostic use*,  therapeutic use*
Anti-Arrhythmia Agents / therapeutic use
Bundle-Branch Block / complications,  diagnosis*,  drug therapy*
Electrocardiography / methods*
Middle Aged
Myocardial Ischemia / diagnosis*,  drug therapy*,  etiology
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Anti-Arrhythmia Agents; K72T3FS567/Adenosine

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