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Retrograde sharp potential resembling the his-bundle electrogram: is this a case of atrioventricular re-entrant tachycardia involving twin atrioventricular nodes with the anterior node exhibiting only retrograde conduction?

Published online by Cambridge University Press:  09 September 2020

Gaku Izumi*
Affiliation:
Department of Paediatrics, Hokkaido University Graduate School of Medicine, Sapporo060-8638, Japan
Hisashi Yokoshiki
Affiliation:
Department of Cardiovascular Medicine, Sapporo City General Hospital, Chuo-ku, Sapporo060-8604, Japan
Atsuhito Takeda
Affiliation:
Department of Paediatrics, Hokkaido University Graduate School of Medicine, Sapporo060-8638, Japan
*
Author for correspondence: Gaku Izumi, MD, PhD, Department of Paediatrics, Hokkaido University Graduate School of Medicine, North-15 West-7, Sapporo060-8638, Japan. Tel: +81 11 706 5954; Fax: +81 11 706 7982. E-mail: [email protected]

Abstract

A 2-year-old male with right isomerism was referred for supraventricular tachycardias. Atrial pacing study revealed that anterograde conduction was only through the posterior atrioventricular node. During the mapping of ventriculoatrial conduction, we identified a sharp potential resembling a His-bundle electrogram with a decremental property at the anterior wall of the common atrium. Catheter ablation for the potential eliminated the anterior ventriculoatrial conduction, thereby indicating retrograde activation of the possible anterior atrioventricular node.

Type
Brief Report
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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