EFO : 2023 ?

This is a 60-year-old patient presenting with palpitations. He had previously undergone an electrophysiological study four years ago. During that study, the following tachycardia was induced.

2023

The tachycardia terminated with a ventricular beat

Here, we are pacing the HRA with an extra stimulus, and we observe a jump when moving from an extrastimulus of 370 ms to 360 ms.

2025

We repeated the study in 2025 and again observed a jump, also associated with an echo.

After induction of the tachycardia, we deliver a synchronous ventricular extrastimulus here, without any modulation of the tachycardia.

This is less suggestive of an AVRT.

 

Here, we were not able to perform overdrive pacing, but since the tachycardia terminated each time with a ventricular beat, we concluded that this was a slow–slow AVNRT.