Need for fast pathway ablation in typical irregular AV nodal reentrant tachycardia in a patient with multiple AV nodal pathways

A case of a 60-year-old male with irregular AV nodal reentrant tachycardia of the common type is reported. Electrophysiological study revealed multipl e antegrade slowly conducting AV nodal pathways and one exclusively retrogr adely conducting fast AV nodal pathway. Despite the recommendation for slow pathway ablation as the treatment of choice in patients with AVNRT, fast p athway ablation was successfully performed in this case due to the risk of total AV black of ablating the slow pathways. The present report shows that there is the rare patient in whom fast pathway ablation is required for cu rative treatment of AV nodal reentrant tachycardia.