Document Detail

Not so innocent bystander(s).
MedLine Citation:
PMID:  19541680     Owner:  NLM     Status:  MEDLINE    
A patient with atrial flutter, intermittent non-sustained wide complex tachycardia and 1:1 AV conduction is reported. Electrophysiology testing showed counterclockwise isthmus-dependent right atrial flutter with conduction via the AV node and an innocent bystander left lateral accessory pathway. This explained the observed intermittent wide complex tachycardia. After successful bidirectional cavotricuspid isthmus conduction block, a sustained wide complex tachycardia with identical counterclockwise right atrial activation and rate occurred. This was due to antidromic AV re-entrant tachycardia with innocent bystander activation of the right atrium mimicking atrial flutter. Accessory pathway ablation effectively stopped tachycardia.
Rakesh Gopinathannair; Chirag M Sandesara; Brian Olshansky
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-06-18
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  11     ISSN:  1532-2092     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-26     Completed Date:  2009-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1230-4     Citation Subset:  IM    
Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, E 318-5 GH, 200 Hawkins Drive, Iowa City, IA 52242, USA.
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MeSH Terms
Atrial Flutter / complications*,  therapy*
Diagnosis, Differential
Heart Conduction System / abnormalities*,  surgery*
Tachycardia, Ventricular / complications*,  therapy*
Treatment Outcome

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