Atypical Fast-Slow Atrioventricular Nodal Reentrant Tachycardia Incorporating a “Superior” Slow PathwayCLINICAL PERSPECTIVE
A Distinct Supraventricular Tachyarrhythmia
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- Published on May 17, 2017RE: VAAV response
- Gregory F Michaud, Clinical Electrophysiologist, Vanderbilt Heart and Vascular Institute
The authors describe a VAAV response during tachycardia induction with double ventricular extrastimuli as shown in Fig 3. This is likely a pseudo-VAAV response. The authors explain that retrograde block is present with the first V extrastimulus, followed by retrograde conduction through both the fast and superior slow pathways. More likely, the first ventricular extrastimulus produces the first retrograde A and the 2nd retrograde A is produced by the 2nd ventricular extrastimulus, both over the superior slow pathway. The fact that the stim-A interval is identical to the proximal CS (cannot clearly identify His A) for each ventricular extrastimulus supports this notion. This pseudo VAAV response has been described during overdrive pacing for fast slow forms of AVNRT.Competing Interests: None declared.