Sinus tachycardia presenting as a wide and narrow complex tachyarrhythmia: What is the 'link'?

Journal of Electrocardiology
Chenni S Sriram, Mario D Gonzalez

Abstract

We describe a neonate that developed alternating wide and narrow complex tachycardias following heart surgery for congenital heart defect. Although the etiology was sinus tachycardia, a premature atrial complex initiated aberrancy due to phase 3 block that was perpetuated due to 'linking' at similar or even slower heart rates. Similarly, there was abrupt transition from wide to narrow complex tachycardia following a premature ventricular complex without a change in subsequent heart rate. This was explained by interruption of linking phenomenon by premature ventricular activation. While the above mechanisms are described in the setting of a supraventricular tachyarrhythmia, this has not been reported during sinus tachycardia.

Citations

Mar 20, 2021·JACC. Clinical Electrophysiology·Chenni S SriramMario D Gonzalez

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