Nodal reentrant tachycardiac in a patient with complete atrioventricular block

Introduction: We hereby present the case of a 74 year old patient with a dual-chamber pacemaker implanted 2 years before who came to the ER for fatigue and dizziness. Methods: Clinical examination revealed an AV rate of 140 bpm, BP = 90/60 mm Hg, while 12-lead ECG showed atrial tachycardia with a negative p-wave in the inferior leads and paced QRS complex. The differential diagnosis of pacemaker mediated tachycardia was excluded by the persistence of atrial tachycardia after inhibition of ventricular pacing. The patient was referred for EP study. Mapping of the right atrium revealed an atrial tachycardia with first activation at the level of the CS ostium. Considering the differential diagnosis pacing maneuvers were performed indicating AVNRT. Results: Radiofrequency ablation of the slow pathway was performed with termination of the tachycardia and stable sinus rhythm. Pacemaker controls performed during subsequent months (1, 3, 6, 12 months) revealed a persistent sinus rhythm.

Search in archive

Submit article


If you wish to receive the Romanian Journal of Cardiology, even if you are not a member of the Romanian Society of Cardiology, please fill in the form below, the annual cost (4 issues) being 195RON.

Payment can be made in the account of the Romanian Society of Cardiology:
RO28BTRL04101205M6647601, opened at Banca Transilvania, the Division for Medical Doctors from Cotroceni.

After having made the payment, please offer proof , by sending a copy from the bill or order of payment via e-mail: