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- W2599670912 abstract "Introduction: Characterization of multiple decremental accessory pathways (AP) can be challenging. Methods: N/A Results: A 29-year old male with minimal electrocardiographic preexcitation and normal heart was evaluated for palpitations without a known tachycardia. Baseline HV interval was 13ms and ventricular activation in the para-Hisian region preceded the delta wave. Programmed atrial stimulation subtly but progressively increased preexcitation, as evidenced by loss of physiologic septal activation (loss of r-wave in V1 and q-waves in I, aVL), with short AVERP (<220ms). AV prolongation associated with a negative HV interval during increased pre-excitation and presence of junctional preexcited beats established the diagnosis of a nodoventricular (NV) pathway. Retrograde conduction was evidently through a left lateral AP with slow decremental conduction and long VAERP (340ms). Depending on the decrement in retrograde AP conduction, reciprocating ventricular echo-beats were reproducible during fixed ventricular pacing. A non-sustained tachycardia (CL 310ms-345ms) was induced with ventricular pacing soon after recovery of VA block following adenosine. The QRS morphology of the echo- beats and tachycardia represented fused NV and AV-nodal conduction decided by preceding coupling interval. Catheter ablation of the concealed left AP was successfully performed with resultant VA dissociation. No further ventricular echo-beats or tachycardias were observed. Ablation of the NV pathway was not attempted." @default.
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- W2599670912 date "2016-06-01" @default.
- W2599670912 modified "2023-10-16" @default.
- W2599670912 title "96-27: Dual decremental limbs in a reciprocating tachycardia- an electrophysiological problem or the lack of it?" @default.
- W2599670912 doi "https://doi.org/10.1093/europace/18.suppl_1.i67a" @default.
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