Atrioventricular Reentrant Tachycardia (AVRT) ECG Review

Atrioventricular reentrant tachycardia occurs when a reentrant circuit is present outside of the AV node through an abnormal conduction pathway that connects the atrium to the ventricles.

This pathway is termed an accessory pathwayor a bypass tract. The presence of this congenitally abnormal accessory pathway is seen in Wolff-Parkinson-White (WPW) syndrome.

If an action potential is able to traverse the accessory pathway and then return retrograde through the AV node ― or vice versa ― a reentrant circuit can be created, resulting in AVRT.

Findings on ECG include the following:

  • a narrow complex tachycardia; and
  • variable findings, depending on the direction of the circuit and location of the accessory conduction pathway.

ECG Example:

1. Chou’s Electrocardiography in Clinical Practice: Adult and Pediatric, Sixth Edition, Saunders, Philadelphia, 2008.
2. Surawicz B, et al. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Circulation. 2009; doi:10.1161/CIRCULATIONAHA.108.191095.