Adenosine insensitive “pseudo antidromic” atrioventricular re-entry
tachycardia: The Duodromic tachycardia
Manifest AP on the electrocardiogram (ECG) predispose patients to
atrioventricular reentry tachycardia, atrial fibrillation (AF),
malignant arrythmias and sudden cardiac death. [1,2] The authors
report a case of a male patient admitted to the emergency room (ER) with
a wide QRS complex tachycardia with no response to antiarrhythmic
therapy with adenosine. The arrhythmia terminated with amiodarone
perfusion and basal ECG showed ventricular pre-excitation. An
electrophysiologic study (EPS) was performed diagnosing two different
accessory pathways (AP) which were successfully ablated. However, 6
months later the ECG showed recurrence of the ventricular preexcitation.
A new EPS was proposed with successful ablation of a third AP.