Supraventricular tachycardia with double trouble

Published:October 28, 2021DOI:
      A 23-year-old healthy woman who was 10 weeks pregnant presented to the hospital with palpitations. Her presenting rhythm is shown in Figure 1A . The tachycardia terminated with administration of adenosine. Her baseline sinus rhythm electrocardiogram (ECG) is shown in Figure 1B. Metoprolol was initiated, but she had a recurrence of tachycardia. What is your interpretation of the ECGs? What are treatment options?
      Figure thumbnail gr1
      Figure 1A: Presenting electrocardiogram (ECG) demonstrating a regular, narrow-complex tachycardia with short RP interval at a rate of 215 bpm. Arrows indicate P waves. B: Baseline ECG demonstrating sinus rhythm with manifest pre-excitation.


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