(FIT)-Module 4 Workshop 6: Electrocardiographic and Electrophysiological Correlations-Asirvatham Case 5 Question

Video Transcription

Video Summary

In a patient experiencing tachycardia, a Hispinal Electrogram was not visible, indicating dissociation. During induced tachycardia, delivering premature atrial contractions (PACs) from the distal coronary sinus (CS) resets the tachycardia without altering the QRS morphology or affecting septal atrial activation. Combining this with a previous observation of retrograde right bundle branch block, the most likely diagnosis is a pathway-to-pathway tachycardia. This involves an antegrade accessory pathway causing a wide QRS, with the retrograde pathway completing the tachycardia circuit, fitting within the spectrum of atrioventricular node re-entry tachycardia with a bystander pathway.

Keywords

tachycardia

Hispinal Electrogram dissociation

premature atrial contractions

pathway-to-pathway tachycardia

atrioventricular node re-entry tachycardia