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Media Gallery

Electrophysiologic mechanism of atrioventricular nodal reentry tachycardia (AVNRT).
Atypical atrioventricular nodal (AV) reentry tachycardia. Often, an inverted P wave is seen just before the QRS complex in leads II, III, aVF. This represents activation of the posterior septum due to antegrade conduction via the fast pathway and retrograde conduction via the slow pathway of the AV node.
Typical atrioventricular nodal (AV) reentry tachycardia. In this electrocardiogram, the P wave appears immediately after or just within the QRS complex. Often a “pseudo R wave" is seen in lead V1 and a “pseudo S wave" in leads II, III, aVF. The retrograde P wave represents retrograde activation via the fast pathway, which is anterior septal and superior to the AV node.

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Author

Brian Olshansky, MD, FESC, FAHA, FACC, FHRS Professor Emeritus of Medicine, Department of Internal Medicine, University of Iowa College of Medicine

Brian Olshansky, MD, FESC, FAHA, FACC, FHRS is a member of the following medical societies: American College of Cardiology, American Heart Association, Cardiac Electrophysiology Society, European Society of Cardiology, Heart Rhythm Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Astra Zeneca, Artivion<br/>DSMB.

Coauthor(s)

Renee M Sullivan, MD, FACC Assistant Professor of Medicine, Department of Medicine, Division of Cardiovascular Medicine, University of Missouri Health System; Staff Physician, Electrophysiology, Harry S Truman Veterans Affairs Medical Center

Renee M Sullivan, MD, FACC is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Medical Association, Heart Rhythm Society, European Cardiac Arrhythmia Society, Group on Women in Medicine and Science

Disclosure: Nothing to disclose.

Chief Editor

Jose M Dizon, MD Professor of Clinical Medicine, Clinical Electrophysiology Laboratory, Division of Cardiology, Columbia University College of Physicians and Surgeons; Attending Physician, Department of Medicine, New York-Presbyterian/Columbia University Medical Center

Jose M Dizon, MD is a member of the following medical societies: American College of Cardiology, Heart Rhythm Society

Disclosure: Nothing to disclose.

Acknowledgements

Marco A Barzallo, MD Consulting Staff, HeartCare Midwest, SC