Antidromic atrioventricular reentrant tachycardia mimicking ventricular tachycardia in the setting of previous myocardial infarction

Clin Cardiol. 2000 Jan;23(1):63-5. doi: 10.1002/clc.4960230122.

Abstract

The differentiation between ventricular tachycardia and broad-complex supraventricular tachycardia can be extremely difficult, particularly in emergency situations. We report a case of hemodynamically compromising broad-complex tachycardia in a 63-year-old man. The patient had previously sustained an anteroseptal myocardial infarction and had subsequently undergone coronary artery bypass surgery because of triple-vessel coronary artery disease. Intravenous treatment with ajmalin terminated the tachycardia and revealed preexcited QRS complexes compatible with the presence of a left-sided atrioventricular accessory pathway. An antidromic atrioventricular reentrant tachycardia (identical to the clinical tachycardia) was induced during an electrophysiologic study. In conclusion, there are several causes of broad-complex tachycardia, even in patients with previous myocardial infarction, and, where doubt exists, electrophysiologic studies should be performed.

Publication types

  • Case Reports

MeSH terms

  • Coronary Artery Bypass
  • Coronary Artery Disease / surgery
  • Diagnosis, Differential
  • Electrocardiography
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / complications*
  • Tachycardia, Atrioventricular Nodal Reentry / diagnosis*
  • Tachycardia, Atrioventricular Nodal Reentry / etiology
  • Tachycardia, Ventricular / diagnosis
  • Treatment Failure
  • Wolff-Parkinson-White Syndrome / diagnosis