AV reentrant tachycardia

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]

Synonyms and keywords: AVRT; AV-reciprocating tachycardia; atrioventricular reentrant tachycaria

Pathophysiology

Electrical activity of the heart is rerouted through an accessory pathway that connects the atria with the ventricles.

Classification

Two types of tachycardias fall under this category:

Antegrade Reentrant Tachycardia

Antegrade conduction is the progression of electrical activity from the atria to the ventricals through an accessory pathway. This leads to a premature activation of the ventrical and shows on ECG as a delta wave during sinus rhythm. Antegrade Reentrant Tachycardia is caused when the electrical activity progresses from the atria to the ventrical through the accessory pathway and reenters the atria through the HIS Bundle. This circular progression continues and overrides the normal conduction system.

Retrograde Reentrant Tachycardia

Retrograde Reentrant Tachycardia is the reverse circuit. The electrical activity progresses normally from the atria down the HIS bundle, but reenters the atria through the accessory pathway. This circular progression continues and overrides the normal conduction system.

Diagnosis

Electrocardiogram

QRS Atlernans

The appearance of QRS alternans as part of a narrow complex tachycardia suggests the diagnosis of orthodromic atrioventricular (AV) reentrant tachycardia which conducts retrograde over an accessory pathway.

Video

Below is a video explaining the mechanism of AV re-entrant tachycardia

See Also

Wolff-Parkinson-White syndrome Lown-Ganong-Levine syndrome