Paroxysmal supraventricular tachycardia with unusual induction. Concealed reentry or automaticity?

Abstract

In a patient with documented paroxysmal supraventricular tachycardia, earlier atrial extrastimuli consistently induced His-ventricle (H-V) block and "atrioventricular junctional" beats, which were always followed by an echo or paroxysmal supraventricular tachycardia. In "atrioventricular junctional" beats, a V wave was preceded by an H deflection with the same intervals as that of the sinus beat. As for the underlying mechanism of paroxysmal supraventricular tachycardia, two possibilities were considered: (1) concealed atrioventricular nodal reentry, and (2) "triggered automaticity."