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J Cardiovasc Electrophysiol. 2013 Mar;24(3):359-63. doi: 10.1111/jce.12027. Epub 2012 Nov 6.

Response to atrial extrastimulus during supraventricular tachycardia: what is the mechanism?

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  • 1Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.


We describe a case illustrating the potential challenges in distinguishing AV nodal reentry tachycardia (AVNRT) from automatic junctional tachycardia (JT). While an early atrial extrastimulus advanced the next His and ventricular depolarization without tachycardia termination, suggesting JT, other features indicated the correct diagnosis of AVNRT. This teaching case demonstrates a novel exception to a recently reported diagnostic pacing maneuver and illustrates the importance of considering response to multiple maneuvers in reaching a diagnosis of SVT mechanism.

© 2012 Wiley Periodicals, Inc.

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