Isoproterenol Facilitation of Slow Pathway Ablation in Incessant Dual Atrioventricular Nodal Nonreentrant Tachycardia

Abstract

Catheter ablation of the slow atrioventricular (AV) nodal pathway is the treatment of choice for dual AV nodal nonreentrant tachycardia. Rapid ventricular rates during incessant tachycardia may compromise catheter stability and increase the risk of AV block. Conduction via the slow AV nodal pathway may mimic junctional beats with retrograde block, which is an indicator to cease ablation. We report a case of incessant dual AV nodal nonreentrant tachycardia where intravenous isoproterenol was instrumental in facilitating catheter ablation by eliminating these two factors.