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Supraventricular tachycardia with double trouble

Published:October 28, 2021DOI:https://doi.org/10.1016/j.hrthm.2021.10.024
      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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      References

        • Fitzpatrick A.P.
        • Gonzales R.P.
        • Lesh M.D.
        • Modin G.W.
        • Lee R.J.
        • Scheinman M.M.
        New algorithm for the localization of accessory atrioventricular connections using a baseline electrocardiogram.
        J Am Coll Cardiol. 1994; 23: 107-116
        • Halpern D.G.
        • Weinberg C.R.
        • Pinnelas R.
        • Mehta-Lee S.
        • Economy K.E.
        • Valente A.M.
        Use of medication for cardiovascular disease during pregnancy: JACC state-of-the-art review.
        J Am Coll Cardiol. 2019; 73: 457-476
      1. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy.
        Rev Esp Cardiol (Engl Ed). 2019; 72: 161
        • Duan L.
        • Ng A.
        • Chen W.
        • et al.
        β-Blocker exposure in pregnancy and risk of fetal cardiac anomalies.
        JAMA Intern Med. 2017; 177: 885-887
        • Bergman J.E.H.
        • Lutke L.R.
        • Gans R.O.B.
        • et al.
        Beta-blocker use in pregnancy and risk of specific congenital anomalies: a European case-malformed control study.
        Drug Saf. 2018; 41: 415-427
        • Lydakis C.
        • Lip G.Y.
        • Beevers M.
        • Beevers D.G.
        Atenolol and fetal growth in pregnancies complicated by hypertension.
        Am J Hypertens. 1999; 12: 541-547
        • Iturralde P.
        • Guevara-Valdivia M.
        • Rodríguez-Chávez L.
        • Medeiros A.
        • Colin L.
        Radiofrequency ablation of multiple accessory pathways.
        Europace. 2002; 4: 273-280
        • Chen S.A.
        • Hsia C.P.
        • Chiang C.E.
        • et al.
        Reappraisal of radiofrequency ablation of multiple accessory pathways.
        Am Heart J. 1993; 125: 760-771