Central venous catheter-induced atrial ectopic tachycardia with reverse alternating Wenckebach periods

A centrally inserted venous catheter may cause atrial ectopic tachycardia. The association of atrial ectopic tachycardia with spontaneous reverse alte rnating Wenckebach periodicity has rarely been reported. We describe a 4-ye ar-old boy with tetralogy of Fallot who developed atrial ectopic tachycardi a with reverse alternating Wenckebach periods postoperatively after central venous catheter placement. All such episodes emerged from a 3:2 atrioventr icular block, followed by runs of 2:1 atrioventricular block with progressi ve shortening of the conducted PR intervals. Normal sinus rhythm returned a fter the catheter was withdrawn to the superior vena cava. Reverse alternat ing Wenckebach periodicity may be a tachycardia-dependent physiologic pheno menon.