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A 14 year old with SVT. Baseline EP study. AH 60, HV 57, no preexcitation Antegrade WCL 420 Decremental with AH jump at 600/390 + echos Block with adenosine Retrograde WCL 430 Decremental with VA jump at 600/420 + echos Block with adenosine On isoproterenol, SVT #1 induced…. SVT #1. - PowerPoint PPT Presentation
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A 14 year old with SVT
Baseline EP study• AH 60, HV 57, no preexcitation• Antegrade
• WCL 420• Decremental with AH jump at 600/390 + echos• Block with adenosine
• Retrograde• WCL 430• Decremental with VA jump at 600/420 + echos• Block with adenosine
• On isoproterenol, SVT #1 induced…
SVT #1
• All consistent with typical AVNRT• RF slow pathway modification…
Slow pathway area
AH 60 AH 50CS pacing 400 SVT 400
Spontaneous
340 340 340 340 340
Spontaneous
SVT #2
• Diagnosis? Next steps?• Attempt at 3D mapping for adjunctive clues…
Right posteroseptal
Slo
w p
ath
way
are
a
Inef
fect
ive
site
s ~
-60
ms
Ineffectiv
e sites
Slo
w p
ath
way
are
a
Thank you!
SVT #2 alone