Orthodromic AVRT With 2 Different Wide QRS Complexes Caused by Bilateral Bystander Nodoventricular Pathways

Mihoko Kawabata, MD, PhD; Shingo Maeda, MD, PhD; Tatsuaki Kamata, MD; Tomoyuki Kawashima, MD; Ryo Yonai, MD; Kaoru Okishige, MD, PhD; Hirotsugu Atarashi, MD, PhD; Kenzo Hirao, MD, PhD

JACC: Case Reports (Dec 2023)

Orthodromic AVRT With 2 Different Wide QRS Complexes Caused by Bilateral Bystander Nodoventricular Pathways

Mihoko Kawabata, MD, PhD,
Shingo Maeda, MD, PhD,
Tatsuaki Kamata, MD,
Tomoyuki Kawashima, MD,
Ryo Yonai, MD,
Kaoru Okishige, MD, PhD,
Hirotsugu Atarashi, MD, PhD,
Kenzo Hirao, MD, PhD

Affiliations

Mihoko Kawabata, MD, PhD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan; Address for correspondence: Dr Mihoko Kawabata, Department of Cardiovascular Disease, AOI Universal Hospital 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-City, Kanagawa 210-0822, Japan.
Shingo Maeda, MD, PhD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan
Tatsuaki Kamata, MD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan
Tomoyuki Kawashima, MD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan
Ryo Yonai, MD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan
Kaoru Okishige, MD, PhD: Yokohama Minato Heart Clinic, Kanagawa, Japan
Hirotsugu Atarashi, MD, PhD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan
Kenzo Hirao, MD, PhD: Department of Cardiovascular Disease, AOI Universal Hospital, Kanagawa, Japan

Journal volume & issue: Vol. 28
p. 102130

Abstract

Read online

We present a case of orthodromic atrioventricular re-entrant tachycardia exhibiting both right and left bundle branch block pattern wide QRS morphologies caused by bilateral bystander nodoventricular (NV) accessory pathways. These wide QRS morphologies came from pre-excitation accompanied by delta waves. In the context of NV accessory pathways, left-sided manifest NV accessory pathways are rare.

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

About the journal

Abstract

Keywords