Dual Atrioventricular Nodal Nonreentrant Tachycardia with Alternating 1:1 and 1:2 AV Conduction: Mechanistic Hypotheses and Total Suppression Using Right Atrial Pacing


  • Financial Support: There was no significant financial support for this manuscript. Financial Disclosures: There is no significant financial relationship with regard to publication of this manuscript.

Address for correspondence: Norman C. Wang, M.D., University of Pittsburgh Medical Center, 200 Lothrop Street, B-535 Pittsburgh, PA 15213, USA. Fax: +412-647-7979; E-mail: wangnc@upmc.edu


Dual atrioventricular (AV) nodal nonreentrant tachycardia is an uncommon arrhythmia with several pattern types. The primary therapy is ablation of the slow AV nodal pathway. A rare pattern type demonstrates alternating 1:2 and 1:1 AV ratios with longer PR intervals during 1:1 conduction. We report the second intracardiac study of this variant and the first case of using right atrial pacing as the ultimate therapy for any pattern type.