The coexistence of Wolff-Parkinson-White syndrome (WPW) and atrioventricular nodal reentrant tachycardia (AVNRT)

Ali Elitok; Gökhan Aksan; Mehmet Rasih Sonsöz; Mehmet Tezcan; Özgür Çevrim

doi:10.1016/j.tjem.2017.12.002

Ali Elitok¹, Gökhan Aksan², Mehmet Rasih Sonsöz¹, Mehmet Tezcan², Özgür Çevrim³

¹Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Istanbul, Turkey
²Sisli Hamidiye Etfal Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
³Sisli Hamidiye Etfal Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey

Keywords: Atrioventricular nodal reentrant tachycardia, Wolff-Parkinson-White syndrome, Radiofrequency ablation

Abstract

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common type of reentrant paroxysmal supraventricular tachycardia that occurs in the presence of dual AV nodal physiology. Wolff-Parkinson-White (WPW) syndrome is another type of supraventricular tachycardia characterized by short PR intervals, delta waves and wide QRS complexes on the surface electrocardiogram (ECG), reflecting atrioventricular pre-excitation. Uncommonly, AV nodal reentry and accessory pathways can coexist. In this case report, we present a patient who had frequent episodes of palpitation and syncope and recently presented to the emergency department (ED) with the complaint of dizziness. We performed successful radiofrequency (RF) catheter ablation of mitral annulus posterolateral accessory pathway and AVNRT which was the cause of the second tachycardia induced during the same session.