Paroxysmal supraventricular tachycardia: A tale of palpitations and neglect in an elderly woman

Abstract

Palpitations in the elderly are mostly of cardiac origin. Atrial fibrillation is the most common arrhythmia in the elderly, whereas paroxysmal supraventricular tachyarrhythmias are uncommon. Here, we describe the case of an elderly woman who presented with paroxysms of palpitations of 15-year duration and who had been undiagnosed till presenting to our geriatric service. The patient was diagnosed to have a slow–fast type (typical) atrioventricular nodal reentrant tachycardia which was successfully managed with ablation of the slow pathway. The long symptomatic period when the patient remained undiagnosed due to neglect is a notable feature of our case. The case also highlights the unified protocol for the management of narrow complex regular tachyarrhythmias and the definitive role of ablation even in elderly patients.

Keywords

• ablation
• adenosine
• atrioventricular nodal reentrant tachycardia
• narrow complex
• slow-fast