Challenges in Clinical Electrocardiography |

Irregular Supraventricular Tachycardia

Edgar Argulian, MD, MPH1; Eric Bader, MD1; Patricia Chavez, MD1; Emad F. Aziz, DO, MB, ChB1
[+] Author Affiliations
1Division of Cardiology, St Luke’s–Roosevelt Hospital Center, New York, New York
JAMA Intern Med. 2013;173(21):2001-2003. doi:10.1001/jamainternmed.2013.10068.
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An 86-year-old woman with a known history of coronary artery disease and a prior percutaneous coronary intervention presented to the emergency department with several episodes of self-resolving chest discomfort occurring at rest. She denied any shortness of breath, palpitations, and diaphoresis. Her home medications included a β-blocker. Her blood pressure was 140/85 mm Hg, and she had an irregular heart rate of 125/min. Figure 1 shows the initial electrocardiogram (ECG) obtained in the emergency department.

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Figure 1.
Irregular Narrow-Complex Tachycardia
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Figure 2.
Atrioventricular (AV) Nodal Reentrant Tachycardia Using the AV Node With More Than 2 Pathways

F indicates fast pathway; S1, slow pathway 1; and S2, slow pathway 2. Intervals are measured in milliseconds.

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Figure 3.
Electrocardiogram in Normal Sinus Rhythm
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