Familiar occurence of atrioventricular nodal re-entrant tachycardia in a mother and her daughter
█ Case report
Borbola József, Földesi Csaba
Gottsegen György Országos Kardiológiai Intézet, Felnőtt Kardiológiai Osztály, Budapest
Although atrioventricular nodal re-entrant tachycardia (AVNRT) is the most frequent, regular heart rhythm disturbance in early adulthood, it is quite surprising that there are only few data on the familiar, potential hereditary contribution to the development of AVNRT.
This case report describes the transcatheter radiofrequency ablation treatment of a mother (45 years old) and her daughter (20 years old) due to their paroxysmal supraventricular tachycardias. The mother had attacks of high heart rate in the last 20 years, her daughter had in the last 3 years, requiring emergency treatment for both of them. There was no evidence of structural heart disease neither of them. The EPS revealed the same typical AVNRT (slow-fast type) in both with the same cycle length (CL: 340 msec). On the same day, first the daughter, later the mother underwent a successful ablation treatment (slow-pathway modification). After the intervention, in the past 12 years there was no relapse, they are free of attacks of AVNRT without any antiarrhythmic treatment.
The familiar occurrence of AVNRT in our case report suggests a rare, genetic contribution to the development of AVNRT. The most common clustering was mother and daughter relationship reported in the literature. First-degree relatives of patients with AVNRT present a hazard ratio of at least 3.4 for exhibiting AVNRT compared with the general population. The history of paroxysmal supraventricular tachycardia amongst the first-degree family members may lead to look for the same tachycardia. Further research may be able to provide a more detailed understanding of the genetic influence of AVNRT and its pathophysiology.