Duodromic atrioventricular reentry tachycardia: a case report of a rare adenosine insensitive supraventricular tachycardia

This case highlights the complexity of the diagnosis and treatment of wide QRS tachycardias in a patient with WPW. In this case, the failure to respond to adenosine was attributed to the use of a second AP as the retrograde limb of the AVRT circuit, a rare phenomenon known as duodromic AVRT. Successful identification and ablation of all APs was crucial in preventing recurrent arrhythmias, and rare mechanisms such as duodromic tachycardia should be considered when standard treatments fail.