Dual atrioventricular nodal nonreentrant tachycardia with alternating 1:1 and 1:2 AV conduction: mechanistic hypotheses and total suppression using right atrial pacing.

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. ©2012, Wiley Periodicals, Inc.