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Dual atrioventricular nodal physiology in young child
International Journal of Cardiology 142 (2010) e3 – e5 www.elsevier.com/locate/ijcard
Letter to the Editor
Dual atrioventricular nodal physiology in young child Salvatore Patanè a,⁎, Filippo Marte a , Eleonora Di Tommaso b , Giuseppina Tindara Pagano c a
Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G(Me) AUSL5 Messina, Italy b Divisione di Pediatria,Azienda Ospedaliera Treviglio-Caravaggio, Treviglio(Bg), Italy c Pediatric Division, University of Messina, Italy Received 2 July 2008; accepted 29 November 2008 Available online 9 January 2009
Abstract Dual atrioventricular nodal physiology has been reported. Atrioventricular nodal reentrant tachycardia is the most common supraventricular tachycardia associated with dual atrioventricular nodal physiology. We present a case of dual atrioventricular nodal physiology in a 12-year-old Italian boy. © 2008 Elsevier Ireland Ltd. All rights reserved. Keywords: Atrioventricular nodal reentrant tachycardia; Dual atrioventricular nodal physiology; First degree atrioventricular block
1. Case report
References
Dual atrioventricular nodal physiology [1,2] has been reported. Atrioventricular nodal reentrant tachycardia is the most common supraventricular tachycardia associated with dual atrioventricular nodal physiology [3–6]. We present a case of dual atrioventricular nodal physiology in a 12-year-old Italian boy. On May 2008,a 11-year-old Italian boy was referred to the Cardiology Unit for a cardiovascular checkup. A history of palpitations was present. Blood pressure values were 110/ 70 mm Hg, the heart rate was 76 bpm, the oxygen saturation was normal. The ECG showed first degree atrioventricular block with isolated ventricular ectopic beats. A Holter ECG revealed first degree atrioventricular block with isolated ventricular ectopic beats (Fig. 1). Bradicardic sinusal rhythm without first degree atrioventricular block was also observed (Fig. 2). Also this case is illustrative of dual AV nodal physiology.
[1] Kiernan TJ, Fahy G. Multiple accessory pathways, dual AV nodal physiology, non-compacted myocardium and patent foramen ovale in a patient with Ebstein's anomaly: report of a case. Int J Cardiol 2007;114 (3):412–3. [2] Chen YJ, Chen SA, Chiang CE, et al. Dual AV node pathway physiology in patients with Wolff–Parkinson–White syndrome. Int J Cardiol Oct 25 1996;56(3):275–81. [3] Germano JJ, Essebag V, Papageorgiou P, Josephson ME. Concealed and manifest 1:2 tachycardia and atrioventricular nodal reentrant tachycardia: manifestations of dual atrioventricular nodal physiology. Heart Rhythm May 2005;2(5):536–9. [4] Arias MA, Sánchez AM. Unusual electrocardiographic presentation of typical atrioventricular nodal re-entrant tachycardia. Int J Cardiol 2007;118(2):e48–50. [5] Ong MG, Lee PC, Tai CT, et al. The electrophysiologic characteristics of atrioventricular nodal reentry tachycardia with eccentric retrograde activation. Int J Cardiol 2007;120(1):115–22. [6] Lee PC, Tai CT, Lin YJ, et al. Noncontact three-dimensional mapping guides catheter ablation of difficult atrioventricular nodal reentrant tachycardia. Int J Cardiol May 31 2007;118(2):154–63. [7] Coats AJ. Ethical authorship and publishing. Int J Cardiol 2009;131:149–50.
Aknowledgement The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [7]. ⁎ Corresponding author. Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G(Me) AUSL5 Messina, Via Cattafi, 98051 Barcellona Pozzo di Gotto, Messina, Italy. Tel.: +39 3402783962. E-mail address: [email protected] (S. Patanè). 0167-5273/$ - see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2008.11.163
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S. Patanè et al. / International Journal of Cardiology 142 (2010) e3–e5
Fig. 1. Holter ECG revealed first degree atrioventricular block with isolated ventricular ectopic beats.
S. Patanè et al. / International Journal of Cardiology 142 (2010) e3–e5
Fig. 2. Moreover, bradicardic sinusal rhythm without first degree atrioventricular block was also observed.
e5
Letter to the Editor
Dual atrioventricular nodal physiology in young child Salvatore Patanè a,⁎, Filippo Marte a , Eleonora Di Tommaso b , Giuseppina Tindara Pagano c a
Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G(Me) AUSL5 Messina, Italy b Divisione di Pediatria,Azienda Ospedaliera Treviglio-Caravaggio, Treviglio(Bg), Italy c Pediatric Division, University of Messina, Italy Received 2 July 2008; accepted 29 November 2008 Available online 9 January 2009
Abstract Dual atrioventricular nodal physiology has been reported. Atrioventricular nodal reentrant tachycardia is the most common supraventricular tachycardia associated with dual atrioventricular nodal physiology. We present a case of dual atrioventricular nodal physiology in a 12-year-old Italian boy. © 2008 Elsevier Ireland Ltd. All rights reserved. Keywords: Atrioventricular nodal reentrant tachycardia; Dual atrioventricular nodal physiology; First degree atrioventricular block
1. Case report
References
Dual atrioventricular nodal physiology [1,2] has been reported. Atrioventricular nodal reentrant tachycardia is the most common supraventricular tachycardia associated with dual atrioventricular nodal physiology [3–6]. We present a case of dual atrioventricular nodal physiology in a 12-year-old Italian boy. On May 2008,a 11-year-old Italian boy was referred to the Cardiology Unit for a cardiovascular checkup. A history of palpitations was present. Blood pressure values were 110/ 70 mm Hg, the heart rate was 76 bpm, the oxygen saturation was normal. The ECG showed first degree atrioventricular block with isolated ventricular ectopic beats. A Holter ECG revealed first degree atrioventricular block with isolated ventricular ectopic beats (Fig. 1). Bradicardic sinusal rhythm without first degree atrioventricular block was also observed (Fig. 2). Also this case is illustrative of dual AV nodal physiology.
[1] Kiernan TJ, Fahy G. Multiple accessory pathways, dual AV nodal physiology, non-compacted myocardium and patent foramen ovale in a patient with Ebstein's anomaly: report of a case. Int J Cardiol 2007;114 (3):412–3. [2] Chen YJ, Chen SA, Chiang CE, et al. Dual AV node pathway physiology in patients with Wolff–Parkinson–White syndrome. Int J Cardiol Oct 25 1996;56(3):275–81. [3] Germano JJ, Essebag V, Papageorgiou P, Josephson ME. Concealed and manifest 1:2 tachycardia and atrioventricular nodal reentrant tachycardia: manifestations of dual atrioventricular nodal physiology. Heart Rhythm May 2005;2(5):536–9. [4] Arias MA, Sánchez AM. Unusual electrocardiographic presentation of typical atrioventricular nodal re-entrant tachycardia. Int J Cardiol 2007;118(2):e48–50. [5] Ong MG, Lee PC, Tai CT, et al. The electrophysiologic characteristics of atrioventricular nodal reentry tachycardia with eccentric retrograde activation. Int J Cardiol 2007;120(1):115–22. [6] Lee PC, Tai CT, Lin YJ, et al. Noncontact three-dimensional mapping guides catheter ablation of difficult atrioventricular nodal reentrant tachycardia. Int J Cardiol May 31 2007;118(2):154–63. [7] Coats AJ. Ethical authorship and publishing. Int J Cardiol 2009;131:149–50.
Aknowledgement The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [7]. ⁎ Corresponding author. Cardiologia Nuovo Presidio Ospedaliero Cutroni Zodda-Barcellona P.d.G(Me) AUSL5 Messina, Via Cattafi, 98051 Barcellona Pozzo di Gotto, Messina, Italy. Tel.: +39 3402783962. E-mail address: [email protected] (S. Patanè). 0167-5273/$ - see front matter © 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2008.11.163
e4
S. Patanè et al. / International Journal of Cardiology 142 (2010) e3–e5
Fig. 1. Holter ECG revealed first degree atrioventricular block with isolated ventricular ectopic beats.
S. Patanè et al. / International Journal of Cardiology 142 (2010) e3–e5
Fig. 2. Moreover, bradicardic sinusal rhythm without first degree atrioventricular block was also observed.
e5