Decremental properties of a concealed nodoventricular pathway

Abstract Introduction The decremental properties of the nodoventricular pathway (NVP) are uncertain. Methods and Results During short RP supraventricular tachycardia, a His‐refractory premature ventricular contraction (PVC) consistently terminated the tachycardia without atrial capture immediately after the PVC. Whereas a slightly earlier PVC failed to reset the subsequent His but terminated the tachycardia without atrial capture one cycle later. Conclusion These observations are diagnostic of slow‐fast atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander concealed‐NVP and can be explained by decremental properties in the NVP itself; greater prematurity of the PVC resulted in more decremental conduction over the NVP, causing the AVNRT termination one cycle later.