Diagnostic dilemma with a narrow QRS regular rhythm at normal rates in a patient with corrected transposition of great arteries

Jayaprakash Shenthar; Maneesh K Rai

doi:10.1016/j.ipej.2015.10.003

Diagnostic dilemma with a narrow QRS regular rhythm at normal rates in a patient with corrected transposition of great arteries

Indian Pacing Electrophysiol J. 2015 Oct 19;15(3):180-3. doi: 10.1016/j.ipej.2015.10.003. eCollection 2015 May-Jun.

Authors

Jayaprakash Shenthar¹, Maneesh K Rai¹

Affiliation

¹ Electrophysiology Unit, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bannerghatta Road, Jayanagar 9th Block, Bangalore 560069, Karnataka, India.

Abstract

A 35 year old male, known case of corrected transposition of great arteries presented with exertional dyspnea and recurrent pre-syncope. 12 lead electrocardiogram revealed a regular rhythm at 75 beats per minute, P waves occurring on the upstroke of T waves and apparent 1:1 P-QRS relationship. The possibilities to be considered - complete AV block with junctional escape, junctional rhythm with 1:1 retrograde conduction, junctional rhythm with isorhythmic AV dissociation and prolonged PR interval have been discussed.

Keywords: AV dissociation; First degree AV block; Junctional rhythm; Prolonger PR interval.