TARGETED ABLATION OF THE NONCORONARY CUSP OF AORTIC VALVE FOR INCESSANT ORTHODROMIC ATRIOVENTRICULAR REENTRANT TACHYCARDIA

Case presented by:

RAMPRAKASH BALASUNDARAM, MD, HYGRIV RAO, MD, SAMUEL J. ASIRVATHAM, MD, AND CALAMBUR NARASIMHAN, MD

A 4-month-old infant was admitted with incessant tachycardia, failure to thrive, feeding difficulties, and episodic sweating. Clinical and echocardiographic examination showed a structurally normal heart. The patient’s ECG during sinus rhythm and tachycardia is shown in Figure 15.1.

Question No. 1: The most likely mechanism of the tachycardia is:

A.Ectopic atrial tachycardia (AT).

B.Orthodromic atrioventricular reciprocating tachycardia.

C.Atypical atrioventricular nodal reentry tachycardia (AVNRT).

D.Atrial flutter.

Intracardiac tracings during the tachycardia are shown in Figures 15.2 and 15.3.

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