Radiofrequency Catheter Ablation in Members of a Family with Atrioventricular Nodal Reentry Tachycardia

Paroxysmal supraventricular tachycardia (PSVT) due to familial preexcitation syndromes has been published. Although the most common cause of PSVT is atrioventricular nodal reentry, familial atrioventricular nodal reentry tachycardia has not been reported. In this report, we describe electrophysiological properties and radio-frequency catheter ablation of a family whose four members developed atrioventricular nodal reentry tachycardia. The father, a 74-year-old man, had intermittent episodes of palpitation accompanied by chest pain for years. During exercise stress testing, PSVT with left bundle branch block and presyncope developed. His coronary arteries were normal. An electrophysiological study (EPS) confirmed his clinical tachycardia was atrioventricular nodal reentrant tachycardia (AVNRT). Slow pathway of the nodal reentrant circus was successfully ablated. The son of the family, a 48-year-old man, had a 12-year history of the paroxysmal palpitation despite medical therapy. During his EPS, atrio-His (AH) jump was detected and common AVNRT was induced on the AV nod2 Wenkebach testing. After EPS, slow pathway was successfully ablated. The sister, 50-year old, had episodes of palpitation which suddenly started and ended for 10 years. During the EPS, common AVNRT subsequent AH jump was induced by atrial S1S2S3 stimulations at isoproterenol infusion, and then slow pathway ablation was performed. The other 44-year-old sister, had a 7-year history of paroxysmal palpitation. Common AVNRT had been diagnosed and ablated at another hospital. All patients remained asymptomatic following the successful ablation procedures. (Türk Kardiyol Dern Arş 2004; 32: 326-330)