Curr Health Sci J, vol. 46, no. 4, 2020

Paroxysmal Atrial Fibrillation of Vagal Mechanism with Episodes of Wide QRS Complex Tachycardia Due to Gouaux-Ashman’s Phenomenon

[Case Report]

O.R. SEQUEIRA(1), O.A. CENTURION(1,2), L.M. MINO(1,2)


(1)Division of Cardiovascular Medicine, Clinical Hospital, Asuncion National University
(UNA), San Lorenzo, Paraguay,
(2)Department of Health Sciences Investigation, Sanatorio Metropolitano. Fernando de la Mora, Paraguay


Abstract:

A 38-year-old male patient consulted for nocturnal palpitations described as fast chest pounding that woke him up from sleep. A physical examination yielded no remarkable findings. A 24-hour Holter ECG monitoring demonstrated nocturnal episodes of paroxysmal atrial fibrillation (PAF) with the coexistence of wide QRS complex tachycardia. To the best of our knowledge, this is the first reported case of nocturnal episodes of wide QRS complex tachycardia during vagally mediated PAF resulting from Gouaux-Ashman’s phenomenon. It is paramount for general physicians to recognize this phenomenon because it should be differentiated from ventricular tachycardia, since prognosis and treatment of both entities are entirely different. General and emergency physicians should be aware in order to improve adequate diagnostic and therapeutic management of the arrhythmic episodes.


Keywords:
Gouaux-Ashman phenomenon; Paroxysmal atrial fibrillation; Wide QRS complex tachycardia; Vagally-mediated atrial fibrillation; Holter ECG monitoring.



Corresponding:
Osmar Antonio Centurion, Division of Cardiovascular Medicine, Clinical Hospital, Asuncion National University (UNA), San Lorenzo, Paraguay, Department of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de la Mora, Paraguay, e-mail: osmarcenturion@hotmail.com


DOI 10.12865/CHSJ.46.04.16 - Download PDF